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PART IV <br />CITY OF LINO LAKES, MINNESOTA <br />APPLICATION FOR TAX EXEMPT FINANCING <br />(Commercial, Industrial, Educational or Health Care) <br />1. APPLICANT <br />a. Business Name — <br />b. Business Address — <br />c. Business Form (corporation, partnership, sole proprietorship, etc.) <br />d. Authorized Representative — <br />e. Principal contact person and telephone number — <br />2. PURPOSE OF REQUESTED FINANCING — <br />a. New Facility (describe) — <br />b. Expansion (describe) — <br />c. Refunding (attach explanatory letter) <br />3. GIVE BRIEF DESCRIPTION OF NATURE OF BUSINESS, PRINCIPAL <br />PRODUCTS, ETC. <br />4. ESTIMATED SOURCES AND USESPROJECT COSTS: (Not required for refunding) <br />SOURCES: <br />Bond proceeds $ <br />Cash <br />Other Loans <br />Total Sources <br />607378v1LN110 121 <br />