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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 600 <br />PAID X450 GC) <br />Rec No <br />Comprehensive Plan Amendment X Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant s\\ N\ Sm Thl.`iCci-.c=cc <br />(Name) <br />Owner S e <br />(Name) <br />\2L - — \C - v-Ac,P a \`l\ 4-9SF -P'cc( <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />l l it<c + c�c>e-s7F n <br />(Address) (Phone) <br />Lot 6, except the South 160 feet thereof, and Lot 7, except <br />the South 160 feet of the East 5.28 feet thereof, Block 1, <br />SL. Juh 's Little Canada Heights, together with adjoining <br />half of vacated road. <br />Description and /or Reason for Request (Cite Ordinance Sections): <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 31 <br />(Signature of Applicant) <br />WHITE— Office CANARY— Customer PINK —file GOLD — Planner <br />7 g' fr9. <br />(Date) <br />