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APP# ' - i6 <br /> SF# %j-111 7 <br /> Date i1 G /5 <br /> CITY OF PEQUOT LAKES DWSMA �l'O <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applican ' �-A L!/-,2-7e(- Phone <br /> Mailing Address t �y- 0� {-' r Email <br /> City,State,Zip <br /> Applicant is: Title Holder of Property: <br /> Legal Owner <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other nn <br /> Signature of Owner,authorizing application: � ,� c �J pce�"3 wv,i <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 pxop involved in this request: <br /> � � <br /> Parcel DD No.4 �V L 1 / Zoning District�_I1 <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning (X) j <br /> ' *Please see the attached Checklist on Page 4. <br /> 2 REV: MAR 2010 <br />