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APP# <br /> ` Date, <br /> v (for office use only) <br /> CITY OF PEQUOT LAKES <br /> D SUBDIVISION RREZ�ONING.APPLICATION <br /> Natne of Applicant J J( ,11 iId A Phone b -7'`/3 <br /> Mailing Address T 0 Pox '36 Finail <br /> City,State,Zip. L S S w a U(V ,561 t'( ) (Pj <br /> Applicant is: Title Holder of Pro <br /> Legal Owner (��/ ( f j 1'QC <br /> Contract Buyer <br /> Option Holder () �) ��}�, 3,D 9 l ss (/11a M& <br /> Agent () (Address 156 �p <br /> Other <br /> I <br /> Signature of Chimer,authotizing application: <br /> (By skV*the owner is certifying that they have read anti a the oW accompaayrng this a lieation) <br /> Signature of Applicant(if different than owner): <br /> (By signing the applicant is certifying that they have read and understood the insttuctians accompan)nng this application) <br /> iV 4n15�t7f oovi rS flf cif' S �/ of 5E Sec "to h 2 2 <br /> -SIAb hQ easeMeAi5 of r CZY4. Sub',-fa Ao&4-,-Try4g k WLA.,u 3 7/ <br /> Parcel ID No. of 0 G? 44 66 AAA Zoning District rn <br /> Nature of request(select only one): <br /> Preliminary Plat( ) <br /> Final Plat ( } <br /> Metes and Bounds X <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 /> ��3- 7'2-11 <br /> /Uls�s� � <br /> / 5�� ' REV: JAN 2005 <br />