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FROM : CITY_OF_PEOUOT_LRKES FAX NO. : 2185687229 Aug. 04 2003 10:54AM P3 <br /> APP St9,1-lo02 <br /> Date 7-15-P-0.3 <br /> tfor offio.user only) <br /> CITY OF PEQUOT LAKES <br /> SUBPIVISION/RE7fOKING APPLICATIO <br /> Name of Applicant fitl/tit/1,_, Phone / / y° <br /> Mailing Address /- Email <br /> CitY,tee,Zip ,1114 L 'b", 191 52 y7a-- <br /> Applicant is: The Holder of Property: <br /> Legal Owner (+� <br /> Contract Buyer 0) (Name) <br /> Option Holder 0) <br /> Agent () (Address) <br /> Other <br /> Signature of Owner,authorizing application: _ <br /> (By signing the owner is co:t tying that they have zead and understood the' ,, ,•'• ,accompanying this application.) <br /> Signature of Applicant(if different than owner): .- <br /> (By signing the applicant is certifying that they have read and mdcrstood the instructions ions ac ing this application.) <br /> Location of property involved in this request: <br /> Fire No. ,Parcel ID No. erg 910306%090 7 Zoning District m R_ <br /> / 719 <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning 7° l;xt•,Fr} ( mac, <br /> Note: 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 Plant hearingsl not be held at <br /> the same meeting. Effective date of Final Plat application will be the date of Preliminary Plat <br /> approval. <br /> • <br /> REV: JAN 2002 <br />