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APP#,mil (:Zj�Z <br /> SF# / - 12;�,-. <br /> Date - C <br /> �-- CITY OF PEQUOT LAKES (for office use only) <br /> CONDITIONAL USE APPLICATION <br /> "`F <br /> Name of Applicant L '�'J .T�y��y^�6�is 6AW Phone ✓ '��`�`�S 7� <br /> Mailing Address �f .�7'o n ' Z Email 4e.C-eV 7-Q S.&-< <br /> City,State,Zip IV/S,5"-,4, A•t <br /> Applicant is: Title Holder of Property: <br /> Legal Owner L 4- T 11--v6'i't n F- # <br /> Contract Buyer () (N e) <br /> Option Holder () f 4, 4' ex <br /> Agent () (A dress) 4 3y <br /> Other <br /> (City,State, Zip) <br /> Signature of Owner,authorizing application (required):---! tirL- <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 /> 5-6 3 y 6: 1&k I LC-17 10 r3 ios-k 2- <br /> Parcel ID No. 227 (3 to oi-o i 0000 q Zoning District ►�ScdeK L <br /> Legal Description (if metes and bounds,attach sheet): Lo 7" 1 O 13 ledt <br /> State nature of request in detail: (What are you proposing for the property?) <br /> What changes (if any) are you proposing to make to this site? <br /> Building: <br /> Landscaping. /2-i-ce' ,JaA- -6 �K <br /> Parking/Signs: 4' A kc;X I - Z b+ 1 y F t, fT A ek S'rcCe <br /> 2 REV: MAR 2009 <br />