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I <br /> APP # <br /> Date 5-/7-64 <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> CONDITIONAL USE APPLICATION <br /> Name of Applicant )b /T" "fit/fiu Phone 2/1-Sg$-`/S V D <br /> Mailing Address p . 1 K S Email J04-"e2-vta Cvw yea 4 it S•x <br /> City, State, Zip Pe�v of (a es /A1"( '7 L <br /> Applicant is: Title Holder of Property: <br /> Legal Owner <br /> Contract Buyer O (Name) <br /> Option Holder () '3 v71 Q . <br /> Agent O ( dress) <br /> Other x,44._, M"! <br /> (City, Sta e,Zip) <br /> Signature of Owner, authorizing application(required): 1A 7 <br /> (By signing the owner is certifying that they have read and uncle ...s i ...$ cti.ns accompanying this application) <br /> Signature of Applicant(if different than owner): /I/ js!� <br /> (By signing the applicant is certifying that they have read . •. understood the• ctions accompanying this application) <br /> Location of property involved in t 's request <br /> 30379 //e 37/ /J f /a2e5 <br /> Fire No. 3a3 , Parcel ID Zoning District g <br /> State nature of request in detail: (What are you proposing for the property?) MoutLi,(r <br /> cMA-to,` Vclloc(t_ e 1i4-ZAN i S.�QtiS. <br /> What changes(if any) are you proposing to make to this site? <br /> Building: K,e_ C.,�ter.' 5<-4 Serv•ile Zekt t 51y. <br /> Landscaping: /e/i,k c- <br /> Parking/Signs: ,(/o/ <br /> REV: JAN 2002 <br />