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~~ 1110 <br />Little Canada, Minnesota PAID ~~~~~ <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit <br />Zoning District Amendment ~ Variance <br />Text Amendment Subdivision <br />Other <br />Planned Unit Development <br />Plan Review <br />Applicant ,.-i -- „ r'~~/~ L (, ~Fi,4J !(. / l .-a. ~ ~ L - ~ <br />(Name) (Address) (Phone) <br />Owner~~~L,i;"" !! <br />t;nr~-~-wZySr~f1 Cif~r-<.~ ~~/. ~ ~~r (~tt i7 <br />S r ~SZ c <br />(Name) (Address) <br />c (Phone) <br />Property Location (Street Address and Legal Description) <br />ti r. ~ r~ i r r 5-F .~ rf~h~ • ! or E~ 5Sr i 3 <br />Description and/or Reason for Request (Cite Ordinance Sections): Cu f <br />. ~ C <br /> <br />h~~ ~ ,`a," ~;Ij <br />~- <br />~i C/ ~3I= ;'_ <br />~• <br />i, ~l~%t <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />~. .ie application procedures and hereby agree to pay all statements received from the City pertainino to additional applica- <br />tion expense. <br />/ Via' <br />Date) v <br />WHITE-Office CANARY-Customer PINK-File GOLD-P <br />io <br />