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APP# 045 9 <br /> Date /V-i9-dr <br /> (far office use or*h <br /> CITY OF PEQUOT LAKES <br /> 6,1 VARIANCE APPLICATION <br /> Name of Applicant n.4 �k Phone,,2 . .L' yD7 <br /> Address W Me 14,0—/74`� � Email <br /> City,State,Zip 1 <br /> Applicant is: Title Holder of Property: <br /> Legal Owned rte, <br /> Contract Buyer () (Name) <br /> Option Holder () <br /> Agent () (Address) <br /> Other <br /> (City,State,Zip) <br /> Signature of Owner,authorizing application: Z'L <br /> (By srgntng the owner is certifying that they have read and t(;d 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 /> Location of pro invylved in this request <br /> 1/ <br /> 5(r �C <br /> Parcel ID No. Zoning District <br /> State nature of request in detail: (What are you proposing for the property?) <br /> r- Ail <br /> What changes (if any)are you proposing to make to this site? <br /> Building 14 r <br /> Landscaping: l el e <br /> Parking/Signs: //'do 1� <br /> REV: JAN 2005 <br />