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APP# / <br /> SF# 11-37. 9 <br /> Date <br /> CITY OF PEQUOT LAKES (for office use only) <br /> CONDITIONAL USE APPLICATION n `/ <br /> Name of Applicant d 10 0L�d �« !(�l n j�\ Phone 2. 33 -J `7 a � ' /�1 e e,� <br /> f p-1 5) 5&6 - 59�� /�P�s, <br /> Mailing Address��(�l0 3 is" <qre(21�-r Email U n f- • ba bpd p m i d C 0 <br /> City,State, Zip La Ke 3 . 5-(0 q 7 0�- etwar k, <br /> Corn <br /> Applicant is: Title Holder of Property: n� <br /> Legal Owner �J � i n5 k,\ .. u h&L( l 0 Yl <br /> Contract Buyer () 1 <br /> Option Holder 1�ao W _(g_ 6 <br /> Agent ( S <br /> Other O &) Fa \ C D 57iU1'-0,f i�! <br /> I <br /> (Ci ,State,Zi,) <br /> Signature of Owner,authorizing application (required): - hn ��Gti` <br /> (By signing the owner is certifying that they have read and enders oo a instructions ac g this a cation) <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 request: <br /> z <br /> e <br /> Parcel ID No .'3 Zoning District <br /> Legal Description (if metes and bounds,attach sheet): <br /> State nature of request in detail:.QWhat are you proposing for the property?) <br /> 1- No rf-h d, c IV ,"i 6W/'/-n, VP : Oh <br /> e C i <br /> What changes (if any) are you proposing to make to this site? <br /> Building. N O n f- <br /> Landscaping: on e- <br /> Parking/Signs: N Q e a n S t t� ilk �f S arrm e S i ze- <br /> `- 4 W-b SV)OU 6 C,ha n q �; apps � cc�;v-r c�' 1� b e ►rY�c e <br /> 6\Jer-'A-v)e- Cvu"4P-v- perrylifs . <br /> 2 REV: MAR 2009 <br />