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APP # —IIA <br /> Date <br /> (for office use orgy) <br /> CITY OF PEQUOT LAKES 0,5-- &9 <br /> SUBDMSION/REZONING APPLICATION <br /> Name of Applicant j! i�41 Phone <br /> Mailing Address �03 6 St, i ng Az e_ , Nd, Email <br /> City, State,Zip ac-,K4 be-n ��Z'e,� Ac.N 5S'w-t <br /> Applicant is: Title Holder of Property: <br /> Legal Owner d!�! it 777 <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> Signature of Owner,authorizing application: ��.�o O a, <br /> (By signing the owner is certifying that they have read and understood the it mi%ow 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 property involved in this request: <br /> 2 9ej 27 Gt • R 1 '!07 Per UT <br /> Fire No. .Parcel ID No. A 90 ;2�e 3 46 g,a4 <br /> Nature of request(select only one): <br /> Preliminary Plat ( ) <br /> Final Plat ( ) <br /> Metes and Bounds (Xf <br /> Rezoning ( ) <br /> Note: Applicants may apply for Preliminary Plat and Final Plat at the same time, but they <br /> must be on separate applications. Preliminary Plat and Final Plat hearings will not be held at <br /> the same meeting. Effective date of Final Plat application will be the date of Preliminary Plat <br /> approval. <br /> REV: JAN 2002 <br />