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APP#GG� /G <br /> Date <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISIONP/r REZONING APPLICATION\ <br /> Name of Applicant 1 `���;� �1 '"� C � �`�'7 Phone <br /> Mailing Address �� C h 4j I I F.mail I V <br /> City,State, Zip Ve <br /> Applicant is: Title Hold e of Prope�rt�y:� <br /> Legal Owner (vY X11 c��( —(jli��I h !I U �Ic �1C <br /> Contract Buyer O (Name) <br /> Option Holder j5 i C t' or <br /> Agent () (Address) 5—&ti <br /> Other -i' �3-( Pad { CtiuCf VKS <br /> Signature of Owner,authorizing application:, / <br /> (By signing the owner is certifying that they have read and derst the instructions accompanying this apphca on.) <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 r est <br /> 53iL C rtrd C f-Cj W-C( <br /> ataT <br /> Parcel ID No. 0 C/) /7 1« 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 />