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• <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant <br />N9 <br />PAID <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />v1 D / N,e— rrt-c --N-t <br />- <br />(Name) 7 (Address) <br />Owner C z-.„- <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br />(Address) (Phone) <br />/30 fr- <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />o 7 A. ,t' ! p1 h rft Ll/t of i1 / . ALL -Z-= <br />>5Cel 41a 6A1712 .;ZZ - j <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. 1 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 />(Signature,--p�f �App)+car/t) <br />t' <br />WHITE— Office CANARY — Customer PINK —File GOLD — Planner e <br />(Date) <br />