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Little Canada, Minnesota <br />APPLICATION FORM <br />475 <br />PAID ` PhD -‘)(i <br />/,;2- k% <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />XX Other AMENDMENT OF PUD Planned Unit Development <br />1 2179690 FOR LOT SPLIT <br />Plan Review <br />53 <br />l /yam. <br />Applicant TODD C. JONES P.O. BOX 25085, MINNEAPOLIS, MN 55458 -6085 339 -100` <br />(Name) (Address) (Phone) <br />Owner TWO S PROPERTIES, INC. SAME AS ABOVE <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />87 East County Road "B" Part of Lots 23, 24 and 43, J. F. <br />Eisenmenger's Garden Lots, Ramsey County, Minnesota and vacated Rosedale <br />Avenue. <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 />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />WHITE— Office CANARY— Customer PINK —File GO L <br />Page 58 (Date) <br />