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APP# <br /> SF# /( -o5 ' <br /> Date/2 -/9 <br /> CITY OF PEQUOT LAKES DWSMA //D <br /> SUBDIVISION/REZONING N APPLICATION <br /> Name of Applicant 46(��C`Y� Phone /gx7F-®77(, <br /> Mailing Address g Email tiJ01 ic41 Il.6)We, <br /> City,State,Zip IV 1\41‘590dtt 1 66 <br /> Applicant is: Title Holder of Property: <br /> Legal Owner <br /> Contract Buyer O (Name) <br /> Option Holder 0 <br /> ) <br /> Agent O (Address) <br /> Other -1/4 <br /> . <br /> Signature of Owner,authorizing application: _ L/le <br /> (By signing the owner is certifying that they have read an. unders .. the instru :-,40111PcaMpanying thiWpplication.) <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 /> pal+ No, 6tufzile_r(AV11 ) <br /> S <br /> Parcel ID No. 2 6(9Zc 2( 6 0%4.z O O O Zoning District <br /> Nature of request(select only one): <br /> Preliminary Plat (.) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning (X) b � <br /> ***Please see the attached Checklist on Page 4. <br /> 2 REV: FEB 2015 <br />