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Little Canada, Minnesota <br />APPLICATION FORM <br />No <br />PAID $100.00 <br />Rec. No <br />518 <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />X <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant STEPHEN & MARY RAIOLO 2601 LAKESHORE AVENUE 481 -1251 <br />(Name) <br />(Address) (Phone) <br />Owner A.R. & JUANITA ENGEBRETSON 154 COUNTY ROAD C EAST <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />154 COUNTY ROAD C E - PLAT 02964 NORTH PARK, SUBJECT TO ROAD, THE N 350 FEET <br />OF THE E 117 FEET OF LOT 6 ALSO W 3 FEET OFE 120 FEET OF N 150 FEET OF SD LOT 6, BLOCK <br />1. <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />WE WOULD LIKE A LOT SPLIT OF THE REMAINING FOOTAGE OF PROPERTY BELONGING TO <br />Al FNGEBRETSON THAT IS ON THE SOUTH SIDE OFEAST ROSE PLACE STREET AND WE <br />WANT THAT PROPERTY ADDED TO STEPHEN & MARY RAIOLO'S PROPERTY, LEGAL DESCRIPTION <br />2601 LAKESHORE AVENUE - NORTH PARK EX N. 350 FT & EX S 135 FEET, THE E 117 <br />FFFT OF I nT 6, BI OCK 1. <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 />(Signature_of Applicant) (Date) <br />WHITE— Office CANARY— Customer PINK —File GOLD — Planner age 17 <br />