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FROM : CITY_OF_PEQUOT_LAKES FAX N0. : 2185687229 Feb. 05 2004 01:14PM P2 <br /> APP #Q Qg <br /> Date ge- -a4 <br /> (for officio use only) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant ear / �, c.Ir. 9 eramaSrya(Phone a/r 7 5,7,a <br /> Address/E 074/6 gw y 3 21 Email <br /> City, State,Tip )."9 ire e r� <br /> • <br /> Applicant is: Tisle Holder of <br /> Legal Owner Cos-47r,v( /4e , IJ 5,27i <br /> Contract Buyer () (Name) r�d f <br /> Option Holder () 6?f7 C� .4eyt <br /> Agent () (Address) /1/ass kac) /tea �5'G'V/ ne <br /> Other <br /> Signature of Owner,authorizing application: <br /> (By signing the owner is certifying that they have and the instnictions ;;,�'! - + :this appiication) <br /> Signature of Applicant(if different than owner): <br /> (By the applicant is certifying that they have read and understood the instructions accompanying this application.) <br /> Location of property involved in this request: <br /> - . . k 5k l l 3‘-i ' A' in- X a W ,' hfer0ota'y4/ <br /> 'RR ri of ogtr�, <br /> 3a 16—.5- 6/0/ ,4 - - p / v'7._ <br /> Fire No. SO 58-5. ,Parcel ID No.2 9d/�S/Ji 4 i 42/ZDa Zoning District <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Firutl Platt <br /> Metes and Bounds ( ) <br /> Rezoning ( ) <br /> Note: Applicants may apply for Preliminary Plat and Final Plat at the saute 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 Flat application will be the date of Pretiminaty Plitt <br /> approval. <br /> REV: JAN 2002 <br />