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APP# <br /> Date /a 15-d(o <br /> (for office use any) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATIO�jN <br /> Name of Applicant . .) 1�-p�-E'��S u� Phone Zs — �(07 <br /> Mailing Address 1-7 Finail U�v�� S �' C(�1•�% , <br /> IJ <br /> City,State,Zip <br /> Applicant is: Title Holder 9f Property <br /> Legal Owner Ty <br /> Contract Buyer () (Name) / <br /> Option Holder C& ?erc-of <br /> Agent O (Address) <br /> Other <br /> Signature of Owner,authorizing application: <br /> (By 6gning the owner is certifying that they have read and understood instrvc—accompanying 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 /> Parcel ID No. 1 `'� L' G' Zoning District <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 /> ,o <br />