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APP#4/--id& <br /> Date <br /> DWSMA7-Q/ <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION ,` ,/ <br /> Name of Applicant 11(7tr--0-) �/" , 7 .,i.0`tj Phone=,2/f J 7`//� 7`6'Sy <br /> Mailing Address.6-7W 910 ��. , � 6 ,Rrnail <br /> City,State,Zip ° / i)71- a-6-- 0/ <br /> Applicant is: Title Holder of Property: <br /> Legal Owner <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent 0) (Address) <br /> Other <br /> Signature of Owner,authorizing application: /' ," <br /> (By signing the owner is certifying that they have read and un erstood the instructions 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 instructions accompanying this application.) <br /> tion of property involved jn this e u t: <br /> /,/,' Mi _%_ <br /> Parcel ID Nod4/ 4.5-1/4., *---c:.2?/D SIS 96 Zoning District__a_4_____ <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Final Plat (X) <br /> Metes and Bounds ( ) <br /> Rezoning ( ) <br /> ***Please see the Checklist attached on page 4. <br /> 2 REV: AUG 2020 <br />