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APP# <br /> Date a3 -,4 t— 7 <br /> (for office use onW <br /> CITY OF PEQUOT LAKES <br /> CONDITIONAL USE""CATION <br /> Name ofApplicaute�.t,, �.'��r� Phone `t <br /> Mail ng Address 9.0. S" 511 Email .�.s r~ _:o..�lnt5 w�c�,1•Ct w <br /> City,State,Zip 1?%h r, R:ye,r . M IV 15644 ,14 <br /> Applicant is: Title Holder of Property: <br /> Legal Owner Jesv. i <br /> Contract Buyer {) {Name) <br /> Option Holder () S .0. %ow <br /> Agent {) (Address) <br /> Other v- MN 6USI t t <br /> (City,State,Zip) <br /> i <br /> �ture of Owner,authorizing application(r+�uired): �'{All wy <br /> (By signing the owner is ceaCtfy 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 caffytog that they have read and undentood the mstmctions accompanying this apphcsticm.) <br /> Location of property involved in this request: yy <br /> V46,*- , <br /> 9.0% L A"06.0n. <br /> ParcelIDNo. Zoning District COr mev-ciM.N <br /> X9//5 <br /> State nature of request in deta>7: {What are you proposing for the property?) <br /> 4 r btu ,r► _m A <br /> What changes(if any)are you proposing to make to this site? <br /> B ut in . cA gk 14 200 Sep rk 9 s Ask;rtigk <br /> landscaping CjA%g%»a OAS ",rep, "cit'n+=nd& A 4&n}%'nA +rt4g <br /> Park ng/Signs: Add:Vr a 'M 0Q6 rkIk%A ACAS W AAA -two si g m, lacaA:8rt5 arl <br /> -Ithe. ,Pr��per�v� <br /> REV: JAN 2005 <br />