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APP#,�2 — ? <br /> Date CI ? <br /> (far office use only) <br /> CITY OF PEQUOT LAKES <br /> LAND USE PERMIT APPLICATION <br /> Name of Applicant E f cz-?�-i,7 Phone <br /> MadingAddress x � ' Fmafl ' s eel/ l e7- <br /> city,State,Zip z° o Sl cj 7 <br /> Applicant is: Title Holder of Property: <br /> (f not applicant) <br /> Legal Owner (} <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> (City,State,Zip) <br /> Signature of Owner,authorizing application(required): <br /> (By signing the owner is certifying that they have read and understood the instructions accompanying this application.) <br /> Signature of Applicant(if different than owner):...f�, 21 ui c,,t..--1 <br /> (By the applicant is certifying that they have read and understood the instructions accompanying this apphcation.) <br /> Location of property involved in this request <br /> Property Parcel ID #on Tax Statement) <br /> Zoning District- r)/i U. ,Lake Name 1l r f <br /> State nature of request in detail: (What are you Proposing for the property? If a new dwelling,indicate <br /> number of stories and foundation tape <br /> I <br /> k <br /> Approved by the Zoning Depat rnent• Date: <br /> z <br /> REV: JAN 2006 <br />