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Little Canada, Minnesota <br />APPLICATION FORM <br />N? 526 <br />PAID $300.00 <br />Rec No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />App V k% Knsh <br />3031 Arcade St. 483 -8939 <br />(Name) (Address) (Phone) <br />Owner Same <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />3033 Arcade St.; The south 85.71 feet of the North 1143.11 feet of Lot 13, <br />Anditions Subdivision No 43, Ramsey County, Minnesota. <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />To divide tract of land into 3 Lots <br />In signing this application, I hereby acknowledge that 1 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 Applica} <br />WHITE— Office CANARY — Customer PINK —File - GOLD — Planner Page 45 <br />Od— o v— 96 - <br />(Date) <br />