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Exhibit A <br />APPLICATION FOR ISSUANCE OF <br />SHAKOPEE <br />PRIVATE ACTIVITY BONDS <br />Industrial, Health Care or Other Non - Housing Non - Profit Projects) <br />1.APPLICANT <br />a.Business Name:Date of Application: <br />b.Business Address: <br />c.Primary Business Contact Name: <br />Telephone number:Email: <br />d.Authorized Business Representative: <br />e.Structure: <br />Corporation Partnership Sole Proprietorship LLC n Other: <br />2.PURPOSE OF REQUESTED FINANCING: <br />New Facility Expansion Refunding <br />3.ESTIMATED PROJECT COSTS: (Not required for refunding) <br />Land <br />Building <br />Equipment <br />Architectural, Engineering <br />Costs of Issuance <br />Capitalized Interest (including discount) <br />Other <br />Total Financing Requested <br />5.AMOUNT OF FINANCING REQUESTED: $of project costs) <br />6.TYPE OF FINANCING PROPOSED: <br />a. 111 Publicly Sold Bonds Privately Placed Bonds (Bonds sold to a Bank) <br />b. Expected Term of Financing Years <br />Page 8