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APP #43-/09' <br /> Date/ — j <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant(ASGn 4 e32(1vi -elistiMDS Phone ZI b qob 443s <br /> Mailing Address 21- fl) EVOLSO6 Q Email <br /> City, State,Zip K�Le, Loan din <br /> Applicant is: Title Holder of Property: <br /> Legal Owner ( <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other / <br /> Signature of Owner, authorizing application: A.4 <br /> (, 0)? I • <br /> (By signing the owner is certifying that they have read and understood the instructions accompanying this application.) <br /> Signature of Applicant('if different than owner): <br /> (By signing the applicant is certifying that they have read and understood the instructions accompanying this application.) <br /> Location of property involved in this request: <br /> 52-Q,90 6 xte on ect. <br /> Fire No. " , Parcel ID No. 910)001 id)b 00000°, Zoning District 1$)- <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning (' ) i /(L( L £,.5/DF 4/17#74Z- <br /> Note: <br /> Applicants may apply for Preliminary Plat and Final Plat at the same time, but they <br /> must be on separate applications. Preliminary Plat and Final Plat hearings will not be held at <br /> the same meeting. Effective date of Final Plat application will be the date of Preliminary Plat <br /> approval. <br /> REV: JAN 2002 <br />