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APP# O.S mod' <br /> Date S" <br /> (for office use oW <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION <br /> Name of Applicant P kZ LAC --/," �S;,,, ,' _ Phone 2 2,5l YV U <br /> Mailing Address 7�4,l Etnail <br /> City,State,Zip <br /> Applicant is: Tide Holder of Pro perty <br /> Legal Owner () <br /> Contract Buyer J (Name) <br /> Option Holder () q,3.5;2 jad A h,, r,(Ze <br /> Agent (Address)l (Address) ��v� �,krs X�l/l1 S�6 SL <br /> Other P 5 <br /> A on ,21 Z <br /> // �- c> <br /> Signature of Owner,authorizing application: <br /> (By signing the owner is certifying that they have read and uodentood the instructions accompanyug 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 r t; <br /> �� ty-, L& k r <br /> -� <br /> Parcel ID No. 9� �'7�D`7� ODd 9 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 />