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Little Canada, Minnesota <br />APPLICATION FORM <br />N9 674 <br />PAID 700.00 <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 />Plan Review <br />Applicant 9 lJ�� c,?g /7C�. <br />(Name) (Address) (Phone) <br />Owner <br />(Name) <br />Property Location (Street Address and Legal Description): <br />c «/7Cee ,1/4 f <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <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 />WHITE — Office CANARY— Customer PINK —File <br />(Signs <br />GOLD—Planner <br />Page 10 <br />