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APP#/A 3 <br /> SF# %1- ��% <br /> Date <br /> CITY OF PEQUOT LAKES DWSMA /► �' <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant /1 !`ti«�� (.i s<LIJ�L- Phone <br /> Mailing Address --L/' C A, -S"CZ) /� l Email <br /> City,State, Zip �6-k- _ (Ile J 7/�-' <br /> Applicant is: Title Holder of Property: <br /> Legal Owner 0 <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent O 1(Address) <br /> Other r <br /> Signature of Owner,authorizing application: ,` ' <br /> (By signing the owner is certifying that they have read andunderstood 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 pto erty ,' v9lved in this request: <br /> Parcel ID No. _'� �%r �J �' �I }/��� 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 />