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APP# ,— <br /> SF# <br /> Date ` - ��0 <br /> CITY OF PEQUOT LAKES DWSMA 2�� <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant L''r / � �/ �'�� ��QCLl1T {� Phone <br /> Mailing Address `t7.��� / �/{��� �7�/ � Email <br /> Ciry,State, Zip ��- <br /> Applicant is: Tide Holder of Property: <br /> Lega1 Owner �' ��ry�� <br /> Contract Buyer () ��e� <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> Signature of Owner,authorizing application: ✓Ia,,�ti„ `'������,� x <br /> (By signing the owner is certifyring that they have read and understoo the instru 'ons accompanying this application.) <br /> Signature of Applicant(if different than owner): <br /> (By signing the applicant is certifying that they have read and understood the instrucrions accompanying this application.) <br /> Loc ti n of property involved in this re uest: <br /> f7��� C�� 1 i�f-� �-TG�C�lS �/�� ���/z �l�/�/27�i(/�% <br /> 1� �/2/����r/ ��Jr4.� <br /> ParcellDN�������o�� � �%�,��e��� ZoningDistrict � <br /> � ��9�3�.�/� <br /> Nature of request (select only one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning (X) �l( �L l �'� <br /> %�l �,��T�K IO/ �1 � i/. <br /> °p� !-�G- <br /> 'k**Please see the attached Checklist on Page 4. <br /> 2 REV: FEB 2015 <br />