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APP#��� <br /> SF# <br /> Date �S�G�G <br /> CITY OF PEQUOT I.E33KES DWSMA �/� <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of A licant( -'rly O� �f� i , , <br /> Pp �� ,-�1L.- �.t`�.S Phone ,J��'���2�2 <br /> Mailing Address __ `�7��,� /�'��/ �S/. Email <br /> City,State,Zip / � <br /> Applicant is: Tide Holder of Property: <br /> LegalOwner `�( 0���'1�1F <br /> Contract Buyer () ��e� <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> Signature of Owner,authorizing application: <br /> (By signing the owner is certifying that they have read and understood the instructions accompanying this applicarion.) <br /> Signature of Applicant(if different than owner): <br /> (By sa'�the applicant is certifying that they have read and understood the instructions accompanying this application.) <br /> Loc tion of property involved in�,s request: <br /> ��/�� �� T,� C�-t�fJ L/��. 1��G��l-�'> 1�!'l���v i <br /> �f..��C���it/ I�L�d'�� <br /> Parcel ID No. '���•-��5��1, ���?�(IS��; Zoning District / .f� <br /> �' � ��.�C�.r/� <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Fina1 Plat (� <br /> Metes and Bounds ( ) <br /> Rezoning ( ) <br /> *** Please see the Checklist attached on page 4. <br /> 2 REV: FEB 2015 <br />