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D <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Conditional Use Permit . -WCiO <br />Comprehensive Plan Amendment <br />Applicant <br />Jwner <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Retail Investment I, LLC <br />(Name) <br />Contact: John R. <br />Retail Investment <br />(Name) <br />N9 /6, Y0 <br />PAID (/OD•00 <br />Rec. No <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />(612) 829 -8979 <br />Street, Bloomington, MN 55438 <br />(Phone) <br />(612) 8209 -8979 <br />Street Bloomington, MN 55438 <br />(Phone) <br />7317 West 83rd <br />(Address) <br />(Bob) Petroff <br />I, LLC 7317 West 83rd <br />(Address) <br />'roperty Location (Street Address and Legal Description): <br />2650 -2698 Rice Street, Legal Description is attached <br />)escription and /or Reason for Request (Cite Ordinance Sections): <br />See Attached Narrative. <br />n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ng and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />n the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />ion expense. Sov Q 0 . '-'c T, i-� <br />g ature of Appli 'nt <br />NI/SITE—Office CANARY — Customer PINK —File GOLD— Planner <br />Page .9. <br />f- <br />(Date) <br />