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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 642 <br />PAID cl5F 4 , Go <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 />PIan,Aeview <br />Applicant D 7T / cct C / OR, tUE <br />(Name) <br />�j Q.tivL -� <br />Owner <br />(Address) <br />M S `f <br />(Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />A,Q c4z) ) E et4_4 al 346, <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />PAID <br />RUG 31 1993 <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. 1 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 />nature of Applicant) (Date) <br />WHITE — Office CANARY— Customer PINK —File GOLD— Planner Page 15 <br />