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br <br /> 15 I u [E ' APP# 2 O3 <br /> FEB 2 4 2023 0 <br /> Date -23 <br /> Z- <br /> By CITY OF PEQUOT LAKES DWS MA <br /> SUBDIVISION/REZONING APPLICATION <br /> n t� Zig-2ao>oo/ti <br /> Name of Applicantlyltf adot(fl c/I [Oki Mit.k6Ws ky Phone N4" 6/2.—61 q- Lel% <br /> `r-ago( is c o iN 54. Tyke@ LW sk.cow- <br /> Mailing Address to-31023 Sp'vice C4. Email ntcr tmota,skr a 1n44.4; <br /> City,State,Zip Pepof Le.65 PIN Soi7.2 <br /> Applicant is: Title Holder of Property: <br /> Legal Owner ( T/Itr G��/, i cru J5 lutakoimity <br /> Contract Buyer (E ) (Name <br /> c, w <br /> Option Holder (Q) `3% i€ L,�1I 54-. <br /> Agent (CJ) (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 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 500,},(,1 of k6YCe s) <br /> 54-",64- <br /> Parcel ID No. O&61/ S 0 5 L{3 Zoning District 60"ft ryttreZcA, J <br /> Nature of request(select only one): Re Zp n<... +C) • <br /> Preliminary Plat ( ) LA.A(- GZ <br /> Final Plat ( ) <br /> Metes and Bounds ( ) —bra—KS L c <br /> Rezoning (X) <br /> Please see the attached Checklist on Page 4. <br /> 2 REV: FEB 2015 <br />