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APP# <br /> SF# <br /> Date <br /> `.. CITY OF PEQUOT LAKES DWSMA /1/�7 <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant Phone <br /> Mailing Address Ernail <br /> City,State,Zip EAU <br /> Applicant is: Title Holder of Pr <br /> Legal Owner <br /> Contract Buyer () (Name) <br /> Option Holder () /(1'q 5 jrM <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 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 /> Parcel ID No. <br /> 2,900 3/OF v,9,9 4A 0 G 0 '7 Zoning District <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> ,U L i fS'11J� � <br /> Rezoning (X) '�kvr'1 �GR i✓ST !�'�A�UQ��1��� �',4 /i <br /> ' Please see the attached Checklist on Page 4. <br /> 2 REV: MAR 2010 <br />