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APP# <br /> Date :�j - 6 <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISfION/R/EZONING APPLICATION <br /> Name ofApplicant�eIIyj J 3r,`t -e L<</5�� Phone "� 5-S V/ <br /> Mailing Address gY03 60- gel l Email <br /> City,State,Zip )Cei Ct 05 ; 141r\, -5- X17 <br /> Applicant is: Title Holder of Property: <br /> Legal Owner a 5 <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> Signature of Owner,authorizing application: ' 15c"--' �� <br /> (By signing the owner is certifying that they have read and rstood the instructions accompanying this plication.) <br /> Signature of Applicant(if different than owner): S14A <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 /> ea54- /'tk C_ i61 <br /> Parcel ID No.,2 9 Q J4 a o F)oo 00 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 />