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Little Canada, Minnesota <br />APPLICATION FORM <br />WX <br />PAID <br />Rec No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment X Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant„Pee e l , SeYS'er 70 ov, Co 11 ) C <br />A/1 / (Name) (Address) (Phone) <br />Owner A/1 i k c' (vva V i/ ��v ! 5 ' Ave J{ 3`»7-2 7/5- (Name) / (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />29 3 7. 17 27/ F z2 3 L, /7` . Cara: t e'/y X/ j Y c E. %0/,4t4/ /% kJ, 1,5,y <br />0/ G K E i r L o - — C c G;17%-• et -7 / f G/ -9 / °ir <br />tnld,r`G ;) Cl / 4 f C7 /f9- '✓e /24JY 5—„v-vex )11:, <br />Description and /or Reason for Request (Cite Ordina nce Sections): <br />c i 77 fterer4 xi:" r1 re' .€1,3" <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 . tements received from the City pertaining to additional applica- <br />tion expense. <br />(r!gnature of Appiican <br />WHITE — Office CANARY — Customer PINK —File GOLO— Planner <br />Page 10 <br />net--i'n <br />