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APP# <br /> _ Sate <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant — _ _ Phone CI�2 2f V- 235-3 <br /> Mailing Address S?' S CotJiq U IV 1, S,,,d�-, l(JD l mail IQV ��an.ttrrvl <br /> City,State,'Lip m n net2,kd IYl S S 3�15� <br /> Applicant is: Title Holder of Property ._ <br /> Legal Owner () Qon 64"Sk d- ``774»+rI11AV�5 <br /> Contract Buyer A (Name) <br /> Option Holder O _ <br /> Agent () (Address) <br /> Other <br /> Signature of Owner,authorizing application: <br /> (By signing the owner is certifying that they have read and understcxxh die instructions accompanying this application) <br /> Signature of Applicant(if different than owner): <br /> (By signing the applicant is certifying that they have read and 7i the instnictions accompanying this application) <br /> Location of property involved in this request: <br /> 1,k & .., 3 7J, J'v>?' zyp z rd oi' /,//5 <br /> Parcel ID No. 0i• b 1 S-�iNO- U E b° 8�S Zoning District irzc r A >' <br /> • a<� /1/D-UO�A UcUU� <br /> Nature of request(select only one): <br /> Preliminary Plat( ) <br /> Final Plat ( ) <br /> Metes and Bounds ( ) <br /> Rezoning <br /> Note: Applicants may apply for Preliminary Plat and Final Plat at the same time,but they must <br /> be on separate applications. Preliminary Plat and Final Plat hearings will not be held at the <br /> same meeting. Effective date of Final Plat application will be the date of Preliminary Plat <br /> approval <br /> REV: JAN 2005 <br />