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I, <br /> APP# <br /> Date 67-,?J-65- <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> SUBDIVISION/REZONING APPLICATION <br /> Name ofApplicantm M <br /> Mailing Address a9a 110-5'/, 41W!j 3-7 / Email J'44a. <br /> City,State,Zip a' <br /> Applicant is: Title Holder of Proms ' l <br /> Legal Owner J' xe <br /> Contract Buyer () (Name) <br /> Option Holder Agent () (Address) /' # �?t_°, l �'!► �� `lr0� <br /> Signature of Owner,authorizing appficatio <br /> (By signing the owner is certifying that they have and the instnxctions ac this pplication) <br /> Signature of Applicant(if different than owner): <br /> (By signing the applicant is certifying that they have rood die insinxctions accompanying this application.) <br /> Location of ro vo in this rt: <br /> A II d%? <br /> �qoa 33-�oocR oc�o9 <br /> Parcel ID No v2 90 A 3 33 Drl C B DdOq 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 />