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03/22/2004 14:49 FAX 218 568 5860 CITY OF PEQUOT LAKES 0 001 <br /> App #D 7 <br /> Date - -[;47 <br /> (for office use only} <br /> CITY OF PEQUOT LAKES <br /> SUBDIWISIONfREZONING APPLICATION <br /> Name of Applicant ( _L r, f' �` h? Phone 37; <br /> Mailing Address ,l' ). U / Email <br /> City, State,Zip fc(1 — _ c 4'7 AJ - <br /> i <br /> Applicant is: Title Haider of Property: <br /> Legal Owner (7) <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other _ <br /> Signature of Owner,authorizing application: _6_�__ _,A . . / <br /> (By signing the owner is certifying that they have read and understood the instructions this <br /> accompanying 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 /> Fire No._ ,Parcel D No c/CJ + ��z c/-) g <br /> `r�Zonis District, 1)(4ez./C"_, <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning (?) -7? c /Z I % 'rh 'C( L <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 />