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APP# OS <br /> Date L/7"aS <br /> (for olfioe use onM <br /> CITY OF PEQUOT LAKES <br /> CONDITIONAL USE APPLICATION <br /> Name of Applicant O <br /> Mailing Address 2 9 O ^ Vp!S**,. a&l F.maii C I e K In o"se a a Co N-► <br /> city,state,zip 1"eQ Ira i L.z Wis . /-(/(/. 576402 <br /> Applicant is: Title Holder of Pro per <br /> Legal Owner : i e Ss.-C 0. C �-2 e- <br /> Contract Buyer () (Name) Ij n Q <br /> Option Holder () 3 2.4J�1 O r 5 l/t•1 c•-- / a <br /> t <br /> Other () (f dress)o 4 L 6 C Y r7-j <br /> (City, tate,Zip) IC <br /> Signature of Owner,authorizing application(required): <br /> (By agnng the owner is certifying that they have read and understood the instructions 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 recprest: <br /> 3 8 �o e"sC 2� <br /> c La 14 1-(e7 <br /> Parcel ID No.2 TCo (Z2 O g IS O 000 G Zoning District <br /> State nature of request. detal (What are y�u p ming for the property?) <br /> What changes(if any)are you proposing to make to this site? <br /> Budding. A do'' p If b�,�-Y- c.,,s 4 `(,c., �- �m . <br /> Landscaping. t '�I X.c �- Od— QrJff#-(,Z <br /> ParEng/Signs: ��..ti l �tr���- Cr�, pia[ : rr.•. T . <br /> 2n�2�•nt!— �a.(�..cir� aDe4�aSpe. <br /> REV: JAN 2005 <br />