Laserfiche WebLink
APP# D=i/ <br /> Date <br /> ._ (for office use oW <br /> CITY OF PEQUOT LAKES <br /> LAND=U ,RMIT APPLICATIOName of Applicant bl'& rn/ Phone 5(o <br /> Mailing Address Q(D by r 13(.0 Email 6,e xd i oV-3 etd <br /> City,State,Zip TQ_ Q U D-� La k. 1'n <br /> �10 <br /> Applicant is: Title Holder of Property: <br /> Leo Owner () Vpl\�t4 -1�lGlQ ✓ <br /> Contract Buyer () (Name) <br /> Option Holder () PD 6)4 3`� <br /> Agent A <br /> Other ( <br /> (City,State,zip) <br /> � <br /> 800 444 4 authorizing application(required: e- <br /> (By sigmng the owner is certifying that they have read and mWerstood the ac ) <br /> Signature of Applicant(f different than own <br /> (By signing the applicant is certifying that they have read and the instructions accompanying this application,) <br /> Location of property in involved in Zt: <br /> request <br /> ``.. <br /> Property Parcel ID(#on Tax Statement) <br /> Zoning District (f 14, ,Lake Name <br /> State nature of request in detail: (What are you proposing for the property? If a new dwellings indicate <br /> number of stories and fo dation type.) i <br /> — u - xu c 1.,t"K N� <br /> Approved by the Zoning Department: Date: <br /> REV: JAN 2005 <br />