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APP# <br /> SF# <br /> Date <br /> �-- CITY OF PEQUOT LAKES DWSMA <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant gLKNI 144-1V(:--7 ek Phone C�i 8 -ox)0 °0359 <br /> Mailing Address 111 jg W OI�e yiEF s-r Email a m avy r76 @ qMG,1. CV m <br /> City, State, Zip <br /> Applicant is: Title Holder of Property: <br /> Legal Owner A.A L( <br /> Contract Buyer () (Name) <br /> Option Holder () b cLt7).e< <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 <br /> 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 <br /> application.) <br /> Location of prope involved in this request: <br /> 54_a& $ , R Brupies 'vi-fb P La-f <br /> UI E 10 2-'a-P W 69FS 'n-f S % W 5 i/� 1V' k/1/4 6- S-E % <br /> P-1,�q <br /> Parcel ID No. Zoning District <br /> Nature of request (select only one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds (X) <br /> 3 REV: AUG 2013 <br />