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APP# I — <br /> S F# V <br /> Date —I —1-0 <br /> CITY OF PEQUOT LAKES DWSMA <br /> SUBDIVISION/REZON NG APPLICATION <br /> Name of Applicant � Phone . <br /> Mailing Addres 6eU 660 Ema ������� � ✓tea¢ <br /> City,State,Zip c5 <br /> Applicant is: Title, �older of P e <br /> Legal Owner '� e ? ' X�' <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other - <br /> Signature of Owner,authorizing applicatio . e7, <br /> (By signing the owner is certifying that they have read and understood the instructions/icompanying 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 ro erty involved in dAs re est: <br /> Parcel ID No..4_� U' f ? , e l Zoning District <br /> Nature of request(select only one): <br /> Preliminary Plat (X) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning ( ) <br /> Please see the attached Checklist on Page 4. <br /> 2 REV: MAR 2010 <br />