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APP# <br /> Date -C- G <br /> (for office use only) <br /> CITY OF PEQUOT LAKES <br /> VARIANCE APPLICATION <br /> Name of Appli cant t,of '50M G t--'13hone ��� 'J 2P— 9,W,-75 <br /> Address g6lo 7/ 'ya-le' IV-142q Email&22- Qn 00 1401 ee os�� <br /> Z "Cf � e DP <br /> City, State, ip <br /> .�6y/ ; <br /> Applicant is: Tiide,�Holder of Property: <br /> Legal Owner ( <br /> Contract Buyer () (,Name) .S / <br /> Option Holder () <br /> Agent O (A dress) / <br /> Other <br /> (City6, State, Zip) <br /> Signature of Owner, authorizing application: &t <br /> (By signing the owner is certifying 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 certifying that they have read and understood the instructions accompanying this application.) <br /> Lo c tion of property involved in this request: <br /> she. 3 6(A Do-s i s <br /> von a. <br /> Parcel ID No. Zoning District <br /> State nature of request ' .de:(What are you propos' g for the property?) - S O' �U <br /> 9 <br /> Ile <br /> r <br /> What changes (if any) are you proposing to make to this site? <br /> Building: <br /> Landscaping: <br /> Parking/Signs: 7 J <br /> Z-.,g h� <br /> REV: JAN 2005 <br />