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APP# -� <br /> Date /l -' <br /> (for office use onlfi <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant 1, S(of f'Pckers cv, Phone <br /> Mailing Address 3 5)3 C00 A`1 '9 c) 17 Email y V Yl1 f.j/$ �A-)a r v,y, r1-et <br /> City,State,Zip tGl U 0 <br /> Applicant is: Title Holde of rop rty: <br /> Legal Owner ( 6 .�(!S0 h 6 - it'cYS 0-1\ <br /> Contract Buyer () (Name <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> Signature of Owner,authorizing application:., <br /> (By signing the owner is certifying that they have read and understood the instaic6ons 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 involy to this request <br /> 3Sd�;3 C, ,1 KcI c,cf <br /> Parcel ID Nom �-��'� Zoning District �C <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' ,I." N 2005 <br />