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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment X Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />to I2 2z3 - Co) <br />Applicant b41-,.1 k( ILI4 -1S , I eCC t 51.113 / 5TFAtIL er 2_77?-- /9ZCµ) <br />(Name) (Address) 557 I-7 (Phone) <br />Owner tr7a),1cc-- rinrfr i s PE 5 C _ E C 2 r t K G t i e 5w.E5sTy. 04 ( i 4) Ego - 27a_ <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />F-cir- '1, h Lc Cc 1 , c��rcv� s �106E- 4b4) ,V43 et -- tALc.,D/<. <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />_p <br />Ld� -/ALL- din t/ r r/ v(i <br />a./i3O- c,uyurP qecewy, „ Jz-f- . /Le L. c._ rJc_Aia t> n _, <br />As <br />,A. I i.iJI,..A..t. di <br />AA- <br />P <br />In si !nmg s applicati /n, I hereb acknowledge that 1 have read a d 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 />Q >4. „6--/ % /4 <br />/iSignatyrree of AAIicant) (Date) <br />WHITE— Office CANARY — Customer PINK —File GOLDi— Planner t' g �° <br />