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<br />Little Canada, Minnesota <br />- APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />can~t~ i'1~2G~ ~ ~.~G1~1''4'I~~ ~~'~-' ~3 <br />(Name) J <br />~~~ 11~~ lo~~ ~~~~~(~~~ ~~ ~~ <br />(Name) I <br />Property Location (Street Address and Legal Description): <br />'~~~ ~% <br />(Address) <br />~~~ <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 />ino end Subdivision Ordinances and current administrative procedures. I .further acknowledge the fee explanation as outlined <br />in application procedures and hereby agree to pay all statements reoei>/ed from the City pertaining to additional applica- <br />tion expense. ~/7 ~- ' ` <br />(i / (~ Y <br />~,( J 1 ~ ~ ' <br />l ZC-'z~L ", ~ (Signature q+~ Applican¢)~ (Da,o~ <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner ,~~-~~f'`,/~(~ <br />PAID <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />biz-b'cS-~BZ.S <br />55 ~~'(~ (Phone) <br />~(n - ~~ zz <br />(Phone) <br />