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t1. &-n ( E cru rt <br /> r 1 ;-TL1! \ APP#A3-02 <br /> r EB 21 2023 SF# <br /> LLADate 2-72,1—Z3 <br /> CITY OF PEQUOT LAKES DWSMA <br /> By SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant Afi 4111A_ - Phone og.,.1 `S 230 - 311 <br /> Mailing Address 0-2.1.4 q 62,14.A. L tics, D V' Email ,lui t t c e V115S KrGt .YWi* <br /> City,State,Zip NI.CSIAra t 01,1\I (510({Iog <br /> Applicantthc <br /> is: ) Title 7o�ler of Pr p <br /> Owner 1 'mss rk it)�clt v <br /> Legal ( <br /> Contract Buyer (Q) (Name) <br /> Option Holder (0 <br /> Agent (Address) <br /> Other <br /> Signature of Owner,authorizing application: Il elr. ! At <br /> (By signing the owner is certifying that they have read and 'erstood the' :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 instructions accompanying this application.) <br /> Location of property involved in this request <br /> n/� <br /> Parcel ID No. rr�-qq l 1c00500 5 00 4 0D01 Zoning District Comm t L <br /> 2� ( OS L <br /> Nature of request(select o y one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning (X) <br /> ' 'Please see the attached Checklist on Page 4. <br /> 2 REV:FEB 2015 <br />