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Little Canada, Minnesota <br />APPLICATION FORM <br />N9 646 <br />PAID;7C1-0 <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 />it/ oil-2971" <br />g0 / 7 Applicant % ilf1 -4% /,CVScD 33-5 Ass <br />(Name) (Address) (Phone) <br />Owner <br />5?1 <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />35 ,os6 <br />m4 S757/ 7 <br />-5& 4-»f ta's— <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />w&pLs LOST' Slb 6 L_RJE AAJvsrME&'r <br />'+ Q <br />2 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 from the City pertaining to additional applica- <br />tion expense. <br />(Signature of Applicant) <br />WHITE — Office CANARY— Customer PINK —File GOLD — Planner Page 27 <br />(Date) <br />tcir <br />