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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />N9 524 <br />Rec No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment XX Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant <br />Owner <br />Gertrude Mostad <br />(Name) <br />Same <br />2720 Noel Drive <br />(Address) <br />484 -5574 <br />(Phone) <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />2720 Noel Drive, Tract A, Registered Land Survey No. 387, Ramsey County, <br />Minnesota <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Divide tract into four single family lots by a Registered Land Survey <br />In signing this application, 1 hereby acknowledge that I have read and fully understand the applicable provisions of the <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as out <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional ap <br />tion expense. a-e <br />nature of Applicant) (Date) <br />.E— Office CANARY— Customer PINK —File GOLD— Planner Page 1 7 <br />