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'1 <br />P L 0 "i' P L I� iJ <br />Ol�lIdER <br />JGII ADDRliSS <br />LEGP.L DCSCRIPTION: LOT_L_ IILOCK <br />_ !, r,� L _ . <br />nPPlicant shall complete this form showing all dimensions of the property <br />structures, and property lines an� distances l�etwcen all e�:isti.ug and pro- <br />posed str�ctures. Also S]104: SOClt1C1] and di.mensions of all streets, <br />rights oc ways, alleys, publi.c facilitic:s, casements and underyround <br />ulilities. <br />INDICATE NORTti IN CIRi'.L� AND SItOP1 P,LL STREPTS AND ALLEYS. <br />PLOT PLnN TO IIE D1'.AL�N AT nt1 APPRO?'R7ATL SC71LE <br />7/w^ certify that- Chc proposed constructiot.'„�i.11 c nfur:n to the above <br />4�lot pl�n(dimensions and uces) and �.hat no chan�7c �,i]:_ bc made wit.hout <br />first obl:aininq approval. <br />��.,v-cr�-c�� , ,'�✓ ./�� n „roval Oatic <br />AppliCanis slgnatuY e II <br />