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APP # CJ'9/ <br /> Date'9—/7 CO' <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> CONDITIONAL USE APPLICATION <br /> Name of Applicant end S ji c ao/(een V Sm i0 Phone a?/8-9(ov' 57CP <br /> Mailing Address I g513 5th gtoci 37/ Email <br /> City, State,Zip bra l h col MO 56401 <br /> Applicant is: T419 Holder of Property: <br /> Legal Owner PE ' Se. £ Colleen 1/Sm d A <br /> Contract Buyer () (Name) <br /> Option Holder () 58801 (2oc/Pen Of . <br /> Address <br /> Other () ( f()'SSW , 010 54,44 <br /> (City, Stat- Zip) <br /> Signature of Owner, authorizing application(required): reAl% <br /> (By signing the owner is certifying that they have read and • =tithe•I . •.ons .' s'1 .!irrtthis 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 propegy in9 ved n uest: <br /> . 0776,1 f 5L 4 /5-2% a q /y Eath L1� <br /> 4j1 e, kr/2a <br /> Z. of' <br /> 30/1-55 O • 31/ , 49a0-6., L• es, Ph -Co • <br /> Fire No. 301 55 ,Parcel ID No. o c1OJ5 /OO A/90CCF Zoning District Sb/e y <br /> State nature of request in detail: (What are you proposing for the property?) <br /> Pa_ <br /> What changes(if any)are you proposing to make to this site? <br /> Building: I m o C/S k 6heAckvizo <br /> . d w. •ing: .�. I 1)1 :_� ' �. . , / . /'a ' ad- /'Y1a� 4,2 <br /> ?AI /AI ;IQSS/ #"' //Of/aC? . Jo <br /> Parking/Signs: Si. k/0 e (P&C'Ci( Ge_ d ", <br /> REV: JAN 2002 <br />