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0,!: <br /> APP# e- " <br /> Date <br /> DWSMA <br /> (for office use only) <br /> `. CITY OF PEQUOT LAKES <br /> LAND USE PERMIT APPLICATION p <br /> Name of Applicant Phone <br /> Mailing Address Email <br /> City,State, Zip �L-- <br /> Applicant is: Title Holder of Property: <br /> (if not applicant) <br /> Legal Owner <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> (City,State,Zip) <br /> Signature of Owner,authorizing application(required): <br /> ( <br /> /A?� <br /> By signing the owner is certifying that they have read and understood the instructions acco anying 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 property involved in this request: <br /> Property Parcel ID (# on Tax Statement) 60 /YC� O Q 6 <br /> Zoning District_e /L ,Lake Name A l-Ig <br /> State nature of request in detail: (What are you proposing for the property? If a new dwelling,indicate <br /> number of stories and foundation type.) <br /> 1 <br /> Approved by the Zoning Department: ' ��( ��_jA) Date: <br /> REV: DEC 2007 <br />