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APP# <br /> Date <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> CONDITIONAL USE APPLICATION <br /> Name of Applicant ejE Phone <br /> Mailing Address `7 3Z [A /r--si ZJ`D_ST Email _S-and <br /> I:a r,� Grat.1¢.z?! ne/` <br /> City, State,Zip ?/,-,L.4 M/✓ -5&!V 2 <br /> Applicant is: Tide Holder of Property: <br /> Legal Owner (vY '&q <br /> Contract Buyer Buyer O (Name) <br /> Option Holder () /4,/87 9 <br /> Agent () (Address) <br /> Other mN <br /> (City,State, 'p) <br /> ignature of Owner,authorizing application (required): �K- C <br /> (By signing the owner is certifying that they have read and understood the ins accompanying this application) <br /> L <br /> Signature of Applicant(if different than owner): <br /> (By signing the applicant is certifying that they have read and understood the ins on accompanying this application.) <br /> Location of property involved in this request: <br /> 37/N : <br /> � �9 D ® Ao7 <br /> Parcel ID No. /e W ,.3�I co (?�e /!/� / Zoning District <br /> State nature of request in detail: (What are you proposing for the property?) <br /> 41 vZ n!G- Rt D E� Fieb m f?o l3i�llSa N /2-'/5f Li/e PTE <br /> i <br /> What changes (if any) are you proposing to make to this site? <br /> Building. ,AAW-8: <br /> Landscaping. A,10 <br /> Parking/Signs: /1/ONE — beAl VOWAJ Wr 77HS T/rrlE <br /> REV: JAN 2005 <br />