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APP# - <br /> Date : /6 <br /> (tor office tie only) <br /> CITY OF PEQUOT LAKES <br /> VARIANCE APPLICATION <br /> Name ofAppficant 00 PA n_ I n t Phone Ac?•29 D3S 3 <br /> Address 6!K C� �� py 0 I� 'SM t t'l 109 Email <br /> City,State,Zip in nft a _ tAK) .5,S309 <br /> Applicant is: Title Holder of Property: <br /> Legal Owner () IJon b,n j k r' r Tom r MAO-5 <br /> T)h�m p 5lttrrX►► <br /> Contract Buyer (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> (City,State,Zip) <br /> Signature of Owner,authorizing application: <br /> (By signing the owner is certifying that they have read and understood the- taxtions accompanying this application.) <br /> Signature of Applicant(if different than owner <br /> (By 0ping the applicant is certifying that they have read and the instructions accompanying this application.) <br /> Location of roperty involved in this request: <br /> "wl,w 14WA 3'71 , 1 v1 Est n nth 04G P111,5694,2'. Sr. <br /> Parcel ID No.i D 15-/tQ- OE.b-of5f 51 Zoning District 6M mV IZ C i a <br /> obi-0/6-- /VO-GDA-- 0 ot>q <br /> State nature of request in detail: (What are you proposing for the property?) <br /> 1m1Zt�/t v rwt s Sat k-62 ct Cave a A9 O&CawfihQ„© - Sw N,o,aeA41 d 4L <br /> What changes(if any)are you proposing to make to this site? <br /> Building: 4'XF AAA a&AT+D C <br /> it <br /> Landscaping. <br /> Parking/Signs: <br /> REV:JAN 2005 <br />