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APP#0G/"/gyp <br /> SF# �'/D <br /> Date /,/— <br /> CITY OF PEQUOT LAKES (for office use only) <br /> CONDITIONAL USE APPLICATION <br /> Name of Applicant 1 �S[',e/ 11Z-4 126-1 Phone 2 SJ5/ <br /> Mailing Address 7C Email cc.�c,C'K fitti'C u s.My <br /> J <br /> City,State,Zip I L <br /> Applicant is: Tide older of Property: <br /> Legal Owner <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent O (Address) <br /> Other <br /> (City,State,Zip) <br /> 1 <br /> Signature of Owner,authorizing application(required): <br /> (By signing the owner is certifying that they have read and understood the instructions accompanying thi licatioa.) <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 /> Parcel DD No. ` Zoning District �IZ� <br /> Legal Description(if metes and bounds,attach sheet): <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. Y <br /> Parking/Signs: <br /> `'' 2 REV: MAR 2009 <br />