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APP# � <br /> Date - <br /> (for office use orty) <br /> QTY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APP it^An N <br /> Name of Applicant_g r�err \ Ax V Phone 746 2$ -07 79 <br /> Mailing Address SZ-t(0 16q.)tS Email <br /> aty,State,Zip Anekoyer, rf)O SS3o`� <br /> -Applicant is: Title Holder of Property: <br /> Legal Owner r1 <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> O�t O "x6w.Add <br /> Signature of Owner,authorizing application: <br /> (BY nB�S the owner is certifying that they have read Aun Hying th4.P.Pjj,.vt;i�nZj) ?L__ <br /> Signature of Applicant(if different than owner): <br /> (BY signing the applicant is cerd4ing tlw they have read and understood the inswxtons accompanying this application,) <br /> Location of property invoked in this rtpuesr <br /> ownS�ip /3� /Jn,�h� Qc}nQe 2°t <br /> Fire No. .Parcel ID No.Z�u3`�Z-3dat�Z)Deo9 Zoning District rM <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 he the date of Pteliminaty Plat <br /> approval. <br /> L <br /> REV:JAN 2005 <br /> L-d Oft:M 9n AL noN <br />