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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 642 <br />PAID `Vt cg Q • 00 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment , / Variance <br />Text Amendment V Subdivision <br />Other Planned Unit Development <br />Plant eview <br />Applicant Trio I ce-4, tZt !mv /tit- <br />l etuttt? AN 53-4-v-{ "6nit <br />(Name) (Address) (Phone) <br />Owner <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />ae-c- 6c _c v'e <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />PAID <br />Nu 31 1993 <br />CITY OF LITTLE CANADA <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 fro - City to ning to additional applica- <br />tion expense. <br />-�($tgnature Of Applicant) t) 0 <br />WHITE — Office CANARY — Customer PINK —File GOLD — Planner <br />(Date) <br />