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APP# �y <br /> S F# <br /> Date <br /> CITY OF PEQUOT LAKES DWSMA /f; <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant (,�a `' ' �,(� Phone <br /> Mailing Address L/ Email <br /> City, State, Zip <br /> Applicant is: Title Holder of Property: <br /> Legal Owner 'D I-1j, 4- 9 '�- zel- Pi <br /> Contract Buyer O (Name) <br /> Option Holder () fy/ 8 <br /> Agent () (Address) <br /> Other <br /> Signature of Owner, authorizing application: <br /> (By signing the owner is cerdfying 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 /> Z//�� fir. <br /> Parcel ID No. °( �� ?� a G A A 00, Zoning District <br /> Nature of request (select only one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds (X) <br /> Rezoning <br /> ' Please see the attached Checklist on Page 4. <br /> �y <br /> 2 REV: MAR 2010 <br />