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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 LJr -0572" %,52.f/N 7 <br />(Name) <br />Owner )41 , = -A/ F<' <br />(Name) <br />Property Location (Street Address and Legal Description): <br />/ QQ %7 l 74 <br />N° 624 <br />PAID 4<GC- <br />Rec. No <br />Conditional Use Permit <br />Variance <br />X Subdivision <br />Planned Unit Development <br />Plan Review <br />(Address) (Phone) <br />J <br />(• ddress) <br />Ico 2 5 /ocx• 3 6/5Av4 /S <br />/221 �1 �; y�Yr <br />7 X // <br />(Phone) <br />2/'-3-0 J)el0 7/9 i / / T I L L ' O di' ()AN Mw <br />/ <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Fey es-7 to I-ekdse. W5 `X /00 / from <br />�l "Ts 3Nd ffs /2 54A?e (force( / Lo- 3 (iI,e LO..sTi*/`si/tT.ES <br />tor ,20 [3L 3 Ge>^ vats <br />/ac --rM rt <br />(e;7 t"-s- A -•4cr. <br />L• / Zo /r/c, -/c •Z Cr /9'75 <br />,a/a, ft Ley' .' ow, 7 <br />In signing this application, I hereby acknowledge that 1 have rep: and full understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative pr edures. I furth- acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all ments receiv from the City pertaining to additional applica- <br />tion expense. <br />'fSignat <br />WHITE— Office CANARY— Customer PINK - -File GOLD — Planner <br />(Date) <br />