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APP # (q1/(71S2 <br /> Date/,? <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant L e_R iac fl-/6171 a S Phone (- r)-717c- <br /> Mailing Address fC)• /eig Email <br /> City, State, Zip ii9C 6.'(/ G% f9 S <br /> Applicant is: Title Holder of Property: <br /> Legal Owner /get;(6-- Gv6_46-//e /t1 <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent _O (Address) <br /> Other <br /> Signature of Owner, authorizing application: <br /> (By signing the owner is certifying that they have read and understood the instructions acco • g this application.) <br /> �t r <br /> Signature of Applicant(if different than owner): �• <br /> (By signing the applicant is certifying that they have read and understood the• 'ons acco ' g this application.) <br /> on of property involved in this request: <br /> Fire No._ ,Parcel II)No. Zoning District /e'` / <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Final Plat (i <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 />