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APP# f-S-�4 <br /> Date,-9 GAS" <br /> ,-'N (for office use oW <br /> CITY OF PEQUOT LAKES <br /> rS��UBDIVISION/REZONIN// G APPLICATION <br /> Name of Applicant J J/ I r4 K4 /r.>✓�H r4►til Phone(L)f) 57 <br /> Mailing Address Er-0: 1.s A4.l d V1 e W Finail <br /> City,State,Zip e aQ e- 22- <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 application: a- <br /> (By mgrnng the owner is certifying that they have read and understood the insmictions accompanying this application.) <br /> Signature of Applicant(if different than owner): <br /> (By signing the applicant is certifying that they have mad and understood the instructioos accompanying this application.) <br /> Location of property involved in this request: <br /> N %2 S"Iz Na) A , -,k VY .-ci /D • 7Z,96&T,e 29 uJ <br /> Parcel ID No.� Q/� S�� G`Q 19 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 />