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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />N9 699 <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 />Plan Review <br />ApplicantP&) —ri y' 1 / 2'i wfrk Lk (at Irk_ Akf3 cl Wao <br />(Name) (Address) (Phone) <br />Owner <br />(Address) (Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />t a" Tuts/. LI 61\6- <br />L ,tt ' Q1/2-1 l LeAbe -( '3 Twin. Lake M.i+i Ur_ <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />.5010 S? foot <br />L <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 />I Iri.las <br />Applicant) Page 1 <br />ignature o <br />fanner <br />7 <br />