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04/06/2004 09:13 FAX 218 568 5860 CITY OF PEQUOT LAKES fj002 <br /> APP# �5�-,3 7 <br /> Date - 1"/ <br /> Ifor office use only) <br /> CITY OF PEQUOT LADES <br /> SCTBDIVISION/REZONEN APPLICATION <br /> Name of Applicant 1q N ( _ Phone -.31 0 3 <br /> M a i l i n g Address P BO 7 C 5 Email 'd n h 0 fiie <br /> vr<iev <br /> City, Stare,Zip s .1 k 461 <br /> Applicant is: Title Holder of Property: <br /> Legal Owner <br /> Contract Buyer {j (Name) - <br /> Option Holder R M <br /> Agent e _ <br /> 0 (Address) <br /> Other <br /> Signature of Owner, application: / / <br /> authot�ng A_4(LLB 1. <br /> ($y signing the owner is certifying that they have 1 iniderstood the instructions accompanying this application.) <br /> Signature of Applicant(if different than o <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 /> Fire No. Parcel ID No. Zoning District--r Iy: a <br /> Nature of OOO 9 <br /> N�(select only one): <br /> Prelun'inary Plat O <br /> Ftnai-Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning ( l .' /e/..64'/ 7:3 _ <br /> Note: Applicant 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 />