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• • N°17 <br />Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <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 />�1 tn.(1-1 -3 -1Ctl <br />Applicant Yf1 1`LQ Q, L \ha Di? ��"tSQ CiQC4( _o CR- \Nt+kTh. BE _vai-SQ,S-53�° <br />(Name) (Address) (Phone) <br />Owner Llti1.Ma'S 0J,e_ YS w, W1- u'x 91c, 4is -0117 <br />(Name) (Address) I (Phone) <br />Property Location (Street Address and Legal Description): <br />MrILVS`7P .. R9 Oc Q IS Sr. NOP -} vCT' Cov -1-10 c- <br />911 tc:Jtt.i G LO UV__ % Pt,at� - A- -TAe <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />LltI ZS f °Qat:IWO :VS t1..I.C. SJL1GC Q6LM\SStoL 1O LOCtcSTT ?\r (VPY_ox 2l k (A' <br />,Mutt c0AQ.D&1 CELITU ■4 U - PHnt P \4PP'OX 7_0' )(in' Pfnn 01SPt*Y <br />RQ KP .tor 4 nGAT NbO t' W2 (W- 91-Y4L PL.4c _ PR9 krAik, <br />14 <br />D <br />V��,� t�QLC> PlAtits J \MUS- 414MvAL.. (NLO Plis151 ttthtc-S N1/4(L <br />Qb t N U Q_SlL`I ti t`c `L pmat &R}S.Q Q. t + L� <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 />--Lt lora <br />(S gnature of Applicant)Page 22 (Date) <br />WHITE — Office CANARY— Customer PINK —File GOLD— Planner <br />