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APP#sO,� � <br /> Date <br /> (for office use orb) <br /> `-- CITY OF PEQUOT LAKES <br /> SUBDIVISIOON/REZONING APPLICATION <br /> Name of Applicant c u.o-)1,(e 12-,�' <br /> Mailing Addre�? y <br /> City,State,Zip l Q y t,��� G�NHS e s_ -��' 7°�, <br /> Applicant is: Title Holder of Property: <br /> Legal Owner () <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> _ Signature of Owner,authorizing applicatio . <br /> (By signing the owner is certifying that they Dave understood the instrcti 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 ro involved in this t: <br /> Parcel ID No�%Q Z?2,.3 4:2Q Zoning District <br /> Nature of request(select only one): <br /> Preliminary Plat( ) <br /> Final Plat ( ) <br /> Metes and Bounds <br /> Rezoning ( ) <br /> — <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 />