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APP#/� <br /> SF# y` <br /> Date <br /> CITY OF PEQUOT LAKES <br /> DWSMA /Z <br /> LAND USE PERMIT APPLICATION For office use only <br /> Name of Applicant + .t ; Phone . <br /> i <br /> Mailing Address Email <br /> City,State,Zip <br /> Applicant is: Title Holder of Property: <br /> (if not applicant) <br /> Legal Owner 0 <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> (City,State,Zip) <br /> Signature of Owner,authorizing application (required): Gtr- J 1 <br /> (By signing the owner is certifying that they have read and understood the instructions accompanying this I pplication.) <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 /> Property Parcel ID (#on Tax Statement) <br /> Zoning District -` ,Lake Name <br /> State nature of request in detail: (Vhat are you proposing for the property? If a new dwelling,indicate <br /> number of stories and foundation type.) <br /> Approved by the Zoning Department: Dater /- <br /> REV: MAR 2009 <br />