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10/13/2004 16:55 6516040972 <br />Oct 12 04 02:46p Janel Russe <br />MENDOTA HOMES <br />E51- 771 -5635 <br />Little Canada, Minnesota <br />APPL!CAT1ON FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant <br />(Name) <br />Owner <br />PAGE 02 <br />p.2 <br />NI -103 & <br />PAIO <br />Rec. Na. <br />Conditional Use Permit <br />Variance <br />/ Subdivision <br />` <br />/ Planned Unit Development C 4) <br />Plan Review <br />(Addrea5LDeCi / L /C! 4-4/,10 <br />$ ttkda -t 4wer k-• 23tf s Va. • Toc4. rt1tA <br />Memel (Address) <br />Property Location (Street Address and Lsgal Oescription): <br />L.+ L, -V106_ 1 MD444-- E y i/ad- _1;as, 044/* <br />'>`Ji'_ `r` - 'G77.7 <br />inhone) <br />( <br />Phono) <br />Description end /or Reason for Request (Cue Ordinance Sections): <br />/l '14 t (C✓fir" ' , ' 1 / / u ' , !r <br />In signing this application, I hereby acknowledge that I have reed and fully understand the applicable provisions of the ion. <br />ing and Subdivision Ordinances and current adminiatretive procedures.l_funher acknowledge the fee explanation as outlined <br />In the application procedures and hereby agree to-Pay alhetatements received from the City pertaining to additional applied- <br />/ ■ <br />lion expense. >? <br />\ . ri1/9,,.r,� It>6.13LlAt ''. <br />/0 , 4 -J4 <br />(Signetura of Applicant) (Date) <br />WHl1e- 0rlirp CANAnt- CutlCnat P■NK -File GOLD- pitmAr: tee <br />aGtlNtUO 311111 N...10 <br />ZB7d <br />040099L199 00:Et 7002 /00/01 <br />