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Little Canada, Minnesota <br />APPLICATION FORM <br />N° <br />PAID 30D .CC <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment ><- Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Applicant Keon G{itIal <br />(Name) <br />Plan <br />figs !l/ iz Pkwy <br />(Address) <br />Owner -123 ! Ke/ena✓l 7 ?S /(44fi?2e <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />7gS /Y<� K <br />Lo -s /D ad // <br />Review <br />&'83 -2232_ <br />(Phone) <br />.Vg3 -2-z3 2_ <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />exknd c/o ve (47 Al- 76 2e 71) <br />12J2GCL /445 /0 a,d /7 <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 />(Si <br />WHITE — Office CANARY— Customer PINK —File GOLD — Planner <br />nature of/Applicant) <br />Page 12 <br />(T2 — O-Y/ <br />(Date) <br />