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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />616 <br />PAID'O cC <br />Rec. No <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant M oC Q f 4)S %S ?2_Lk.) t,'i 1-P biz q.Q /lire— "7"77— 7-7.i q <br />(Address) (Phone) <br />Owner <br />(Name) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />�9 0Gf■/750 % /- L-e/ e4 - 29- 22 - Z/— oo3S <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />/// e4.-4•72/€. c /€. <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. 1 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 37 `1.113 <br />/(Signature o Applicant) <br />WHITE— Office CANARY — Customer PINK —File GO D — Planner <br />/ /- /T— iL <br />(Date) <br />