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N? (17 <br />Little Canada, Minnesota PAID 4700.00 <br />APPLICATION FORM <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 />M <br />Plan Review <br />Applicant R( JFY?2N / 3 !doge 49.1 <br />/YA 79 /U/ X7CJ <br />(Phone) <br />(Name) <br />Owner NO espPlaser•/ <br />(Name) <br />(Address) <br />Property Location (Street Address and Legal Description): <br />(Address) <br />(Phone) <br />5o, AT of L O Z- /3/ 3/ <br />62 C'VY/r/5 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />/ e;eOU ; LO ij /S g7' F-e7- ep, / �/S ZoCtCcc/ /)e/z4;eev <br />/ / <br />/?e /0 1 721,-/ o /LG %O /53- cPy L-,TS a, /T/t 27' /1/e�cl <br />LOT ` -fi(=/ . G (155/& /42 we. <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 GC <br />�• ,_ 47- <br />/CZ 12G Ai(; <br />4AL 3 -9V <br />nt)/ <br />Page 17 <br />