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-\ <br />~~ x~'',~^1121 <br />Little Canada, Minnesota PAID`~_ <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit <br />Zoning District Amendment <br />Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant ~~.~'Y\ V~ ~o~e~ 2~0~ ~1~E S~', _bSl-ulu36b <br />(Name) l~~~j ~S'~oY~~. fre~C~~C~=C ~Q I '~ 5S)~~) <br />Owner <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />~-~~O tQ. )cA ~- ~~I~ C~.c~ ~- , ~ r~ S54 L~ <br />In signing this application, I hereby acknowledge that 1 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 all statements received from the City pertaining to additional applica- <br />tion expense. <br />(Signature of Applicant) ( ate) <br />WHITE-Office CANARY-Customer PINK-Fife GOLD-Planner ~o <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />