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APP# /&:7�4 <br /> SF#/ / <br /> Date <br /> CITY OF PEQUOT LAKES DWSMA ZVO <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of ApplicariQ �' . <br /> �S Phone <br /> Mailing Address r �( � Email <br /> City, State, Zip ' <br /> Applicant is: Title Holder of Property: <br /> Legal Owner <br /> Contract Buyer O (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> Signature of Owner, authorizin g a Pp licatioQa <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. jG/C� ?��J f� lCi' J 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 /> 2 REV: MAR 2010 <br />