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,~ <br />--~ <br />~~' 11~ <br />Little Canada, Minnesota PAID ~aa~ <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant ~~'v ~r~n rl~ /~~;vr~~"~~~ <br />(Name) %-r <br />Owner ~~.Ev~. v1 S-\T i rl~r"~ ~-i <br />(Name) <br />Property Location (Street Address arid Legal Description): <br />Variance <br />Subdivision <br />/ Planned Unit Development <br />~-! Plan Review <br />(Address) ~ y~,'3 y 4r (phone) <br />ress) (Phone) <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 />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />he application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />t~~n expense.~_~Q1~ <br />(Si~ure of Applicant s Datel ~~ <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner ern <br />