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a <br /> APP # <br /> Date 7d6, -0 a C� <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION ,� , <br /> -- / car <br /> Name of Applicant ci on L Phone 517 -4/7 4 <br /> r,� s <br /> Mailing Address 39 75- 3a f and \f Email -4 <br /> City, State,Zip INE iVg'e-- IQ a6'471 (3‘4° ' <br /> Applicant is: Title Holder of Property: <br /> Legal Ownert NWT <br /> Contract Buyer (Name) <br /> Option Holder 0) .3a/ 5' 3 a7"0 a, i •Vd <br /> Agent () (Address)l,�� <br /> Other <br /> Signature of Owner,authorizing application: . ' 42,- <br /> (By signing the owner is certifying that they have read and(.- • the instructions acco • g 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 /> ItAT?;it. Lid J — <br /> Fire No. h Q- ,Parcel No. Zoning District <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Final Plat <br /> Metes and Bounds ( ) <br /> Rezoning ( ) <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 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 />