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Little Canada, Minnesota <br />APPLICATION FORM <br />No 6 98 <br />PAID �-.L_•VV — <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 />Applicant TNOR9/tS J ys/H /i6 <br />(Name) (Address) <br />Owner <br />2623 5PRI~a. sr <br />(Name) <br />V -aV3, <br />(Phone) <br />Ul ov CA /20 Jr ST, jf,Fc/ —z /ci 9 <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />02400 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />tet <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 />(Signatu - of Applicant) <br />WHITE —Office CANARY — Customer PINK —Pile GOLD— Planner Page 2 <br />�7- 25-95 <br />(Date) <br />