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I <br /> APP� -/� <br /> SF# <br /> Date <br /> ----.-�__—� <br /> CITY OF PEQUOT LAAgEES DWSMA�C�_ <br /> SUBDPVISI4N REZ0IVING PLICA'TION <br /> f��.fr.�' ! f <br /> Name of Appfic�nt �S�s, r �Yr/t'l � Phone�lfi-�"�-c��i <br /> Ma�7ing Adaress d!�-� Y��' Finat1 w�r-�c�``��D r.�s t���'.,�7`� <br /> �Y�S+��p T�����ts, .�l/I/ ��5��� <br /> � <br /> ���' T' Holder of Prop�r�.p: <br /> �°vB� `� 1'��-z �e ��..z..' �"���/ <br /> Option Ho�det () �� �� � � <br /> A�g�n� �� �A�� � �� <br /> Si�natute of Owner,autho=jz�apphp��; <br /> (�Y��owaer is certifyiag tbat thry bave nead and undetstood ths iusm�ctioaa �nPP��) <br /> Si�a�e of Applicant(lf di�ecent diaa owner): <br /> �r�S��PP�cant is catifping that th�y have neaa ana undets�ood the;asttucdons acco�y;ng tiris applicatian.) <br /> Location of properiy involved in this r�� <br /> Pazcel m 1Vao?�D.? /�o��'/?�'l����sz�gDisttict <br /> Natute of t�quest(select only one); <br /> Pre�minat9 plat(� . <br /> Fnnal PL�t ( ) <br /> Mctes and Bounds ( ) <br /> Rezoning � ) <br /> '�'*Pleasc see th�attacLed CLeckiist oa Page 4. <br /> 2 REV:MARCN 2018 <br />