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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant E,R-vWO ft' M <br />(Na e) <br />Owner 6Edtt✓ \£utL- <br />(Name) <br />N9 612 <br />PAID <br />/i o <br />�3(�r� • 0 <br />Rec No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />//a7 -I sukE ekFA tc. <br />(AddreAs) <br />6,3 ' D. <br />stn Tt£1lvE <br />(Address) <br />Property Location (Street Address and Legal Description): <br />46. F6SC/78ellia? <br />(Phone) <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />keVIIL)e\ L.1\ t1 <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 27 * 9JVY'.L•tiAN <br />(Signature of Applicant) <br />WHITE — Office CANARY — Customer PINK —File GOLD— Planner <br />