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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 658 <br />PAID 4700. 00 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment � Variance <br />/ <br />Text Amendment \ / Subdivision <br />Other Planned Unit Development <br />Plan Review <br />E `�� j <br />Applicant oM E a ,S / /IP� S 3o3C ��e�k iC� (,Uc y —725— °IS98 <br />(Name) (Address) (Phone) <br />Owner 3-CL(y) e S �� o f Soy\ 29 30 94,6, ov IO <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />3015 A r'co cL 31- <br />See 4 c e_ci Paper `roc �oY. j Lr? c�, <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />S p ) 2 Nr°, J 1-045 <br />C-A, e dcy woi <br />a y e f- J. I A; s Pro vi e <br />14514 0-I-L. I /_S . <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 />.c/ ( 3 -9`-/ <br />(Signature of Applicant) (Date) <br />WHITE— Office CANARY— Customer PINK —File GOLD— Planner Page 66 <br />Via, m <br />