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_~ r'1 <br />~~ 1 11 <br />Little Canada, Minnesota PAID ~~_ <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Variance <br />-_.~_ Subdivision <br />Other <br />Applicant v ( r <br />(Name) <br />Planned Unit Development <br />Plan Review <br />Gam/ 7~~-°'c/`/ <br />a9Dq ~GP~hr,~~ r Sfi ~iZ abs =zz~Y <br />(Address) <br />(Phone) <br />Owner D P ~ k I~SS ~~ L • (5 r~~ ~ 6~l ye'S~- 737.E <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />~"7 ~, t3 (y~ ,~ s f. <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ir• and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />i e application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />(Si ture of A licant) (Date) <br />WHITE-Office CANARY-Customer PINK-File GOLD-PIa ner .v,-~o <br />