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APP# 07-QS <br /> Date aG -v 7 <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant _66 c.r- Phone <br /> Mailing Address \(:A `� �-cjrx,-- f1W Email <br /> City,State,Zip Avicko de-�� mtJ S Sao L4 <br /> Applicant is: T4PHolde r of P erty: . <br /> Legal Owner (LK 0 r I c .,1' — c� l <br /> Contract Buyer () (Name / <br /> Option Holder () 22 / qj <br /> Other (� � )ve r �� <br /> O <br /> Agent v� <br /> Signature of Owner,authorizing application: <br /> (By signing the owner is certifying that they have read and anti tood 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 underYtood the instructions accompanying this application) <br /> Location of property involved in this request <br /> `, Tlnt SGU- W es! � C,),,,o rye r- v k e+ 1 <br /> St'C.�o.-� 3� lu�lYS1..(� ��J� �.)-� � \�C�"�5,� 2� �1� Crcu i:.x� �J�.t.�. M•v�n+�t'1�t <br /> Fire No. ,Parcel ID No. Zoning District i:�v e-sy MccnCjty-,V <br /> Nature of request(select only one): <br /> Preliminary Plato <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 />