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~°• .11_~ <br />Little Canada, Minnesota PAID i r--c <br />- -- APPLICATION FORM <br />Rec. No.~_ <br />Comprehensive Plan Amendment ° Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Suladivision <br />Other <br />~u;>~,>r t ~e~ ~et~a~ <br />Applicant ~'~ <br />(Name) <br />'~.bi n <br />Planned Unit Development <br />Plan Review <br />(Add~~ SS I Z~ ~ (Phone) <br />Property Location (Street Address and Legal Description}: <br />MN ss i ~~-- <br />)escription and/or Reason for Request (Cite Ordinance Sections): <br />.._ <br />- z(~ - ©~sE <br />~~~Z, ~.(~~~~~ ~ Ill-(l! SS(Z,~ <br />r signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon <br />ig and Subdivision Ordinances and current administrative procedures. further acknowledge the fee explanation as outlinec <br />t' 'application procedures and hereby agree to pay all statements r c ived from the City pertaining to additional applica <br />or. _,cpense. <br />~/~ti pp ~ { <br />l ~~ 2~ ~ ~ ~ (Signature of Ap lic t <br />-0TE-Offi re CANARY-Customer PINK-File GOLD-Planner (Date) <br />~~/ r,7 <br />