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`~ ~ .. <br />~~ 11.15 <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 x Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant ~~'~- Iz. ~~5~(~ ~f 23ss ~~-~, rv'rtw Ave ~k2so bit 61 b z~ 9>3 <br />(Name) (Address) RosavrUe- ~" l ~ ss'~~3 (Phone) <br />Owner ~~Vit.) ~ickers ~}w~~ (owl SQZ 3~(y3 <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />~'~ -'- 7S D~~to~T- ~v~ ~-+sy-, L~7rtL' C~,vkd~r+ MrJ SStl7--~~{~ <br />~ ~Lf (-~e~ r.~ l c LeT~ Z <br />~T P /~w d S s r~ rM R, ~2J w <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />7TrVQ Tw;A! Llvr+~re <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />inn 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 />Z/~I~ 7 <br />(Sig r, of Applicant) (Date) <br />WHITE-Office CANAR V-Customer PINK-File GOLD-Planner .g~~~o <br />