Laserfiche WebLink
APP# <br /> SF# <br /> Date <br /> CITY OF PEQUOT LAKES DWSMA <br /> LAND USE PERMIT APPLICATI4N For office use on�y <br /> � <br /> Name of Applicant �l�f��`l� � ,'/�c4- � C�� '7 �� Phone <br /> Mailing Address��� L�/i�'� L i��t �� / �--_ Email <br /> Ciry,State,Zip �� ,(_'� /�t.��_�'� � 6'"Z I K�� � � �4 / <br /> Applicant is: Title Holder of Property: <br /> (if not applicant) <br /> LegalOwner (�,Y <br /> Contract Buyer () ��e� <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> (Ciry,State, Zip) <br /> Signature of Owner,autlzorizing applicarion (required): :� <br /> (By signuig the owner is certifying that they have read and understood the instructions accompanying this application.) <br /> Si�mature of Applicant (if different than owner): <br /> (By signing the apphcant is certifping that they have read and understood the instructions accompanying this application.) <br /> Location of prope involved in this re uest <br /> �. � � ���� �I <br /> Property Parcel ID # on T� Statement) �% /� L^'��l <br /> Zoning District _ Lake Name �{� <br /> � <br /> State nature of request in detail: (What are you proposing for the property? If a new dwelling,indicate <br /> number of stories and foundation type.) <br /> _ ' l �F �.��T��,c�C�� �:i CT nl <br /> � �ti� 7� �,c/.yL • ��.,,c�f��� <br /> Approved by the Zoning Department: Date: <br /> REV:MARCH 2O19 <br />