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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment Conditional Use Permit �'- <br />N? 598 <br />PAID 206 <br />Rec. No <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant C eED /_ rE/V/% /1/1 (Da } 4-7 cE Se z Er 5<ke <br />(Name) (Address) (Phone) <br />3'0 77, /i c6 Cr S s ./ <br />Owner Sn ne <br />(Name) <br />Property Location (Street Address and Legal Description): <br />95 A-9/ SYReeC <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />K /D y/7 /lle,764,o%17Le on T/c ovi(<j e off <br />Ssio(e cfrd64 _ <S Ae 4q4 Ale CS�ti -eif <br />S (et? SigLe 4i my <br />use ICI KetS, <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />Page 24 <br />(Signature .f Applicant) <br />WHITE — Office CANARY— Customer PINK —File GOLD — Planner <br />