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APP# <br /> SF# <br /> Date - / <br /> CITY OF PEQUOT LAKES (for office use only) <br /> CONDITIONAL USE APPLICATION <br /> Name of Applicant ✓l hdne <br /> Mailing Addresso ©04� "y Y_o rte' sue° Email J✓t <br /> City,State,Zip d a `+"h i R�� e r U 0• CL-71v\ <br /> Applicant is: Title Holder of Property: <br /> Legal Owner Su Old Gek 0%4 <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> (City,State,Zip) <br /> Signature of Owner,authorizing application (required): k' -- <br /> (By signing 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 request: <br /> MtO oV&gers' sS <br /> Parcel ID Noc:`;-q 117 &V �17& Cr 9 Zoning District <br /> Legal Description (if metes and bounds,attach sheet): ©LA, Q p <br /> 1} <br /> State nature of request in detail: (What are you proposing for the prope ?) <br /> Ll O.&A +-e-G1 , `A 4-,x ay ! �n 0/�t1 aA C1 A 0.M n.P <br /> What changes (if any) are you proposing to make to this site? <br /> Building. 4644.1 <br /> Landscaping: 40 <br /> Parking/Signs: c S ors <br /> wf r.a ti e <br /> 2 REV: MAR 2009 <br />