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Date ( - <br /> (for office use on}y) <br /> CITE'OF PEQUOT LAKES <br /> VARIANCE APPLICATION <br /> n <br /> Name of Applicant ODD i&Oa n 1 ►)C Phone '25.3 D 3 S3 <br /> Address 6,J125- Csur244 %D) S 12.60, <br /> City,State,Zip,4�1ir7n 2IaVA c IN"V S S3L/� <br /> Applicant is: Title Holder of Property: <br /> Legal Owner () 1�Dn3Ab,n5k i �r n1q V 15 brrii�m�52J+� <br /> Contract Buyer `,(i (Nauss) <br /> Option Holder (} <br /> Agent (} (Address) <br /> Other <br /> i (City,State,Zip) <br /> Signature of Owner,authorizing application: <br /> (Bp signing the owns*is certifying that they have lead and undesst� /instructions acv ping this application) <br /> Signature of Applicant(if different than owner):, <br /> (Bp signing the applicant is cerEfying that they have read and under tmctions accompanying this application) <br /> I� � d <br /> I Location of property involved in this request: <br /> i a,1-0i5- 14D-08:e) -big 1 �^ <br /> Parcel ID No. 5- 4'40- OTC - D O 21 Zoning District /d 1 <br /> 410- 0040-V,%09 <br /> State nature of request in detail: (What are you proposing for the property?) <br /> See A)44&A'f.,ye. - <br /> i <br /> i <br /> What changes(lf any)are you proposing to make to this site? <br /> Building Sm Nt i rra+i ue <br /> i <br /> Landscaping. <br /> I <br /> Pad ineSigas: <br /> I <br /> i <br /> i <br /> REV: JAN 2005 <br />