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0 <br />P L O T P L A N ' <br />OI+lNER ' ' <br />JOB ADDRESS � ' <br />LEGAL DESCRIPTION: LOT BLOCK OP <br />Applicant shall complete this fo'rm ahowing all dimensions of the property <br />structures, and.property lines ans distances between a11 existing and pro- <br />posed structures. Also snow location and dimensions of all streets, <br />rights of ways, alleys, public facilities, easements and underground <br />utilities. ' • <br />INDICATE NORTA IN CIRCLE AND SHOi�l AI,L STREETS AND ALLEYS. <br />PLOT PLAN TO BE DRAWN AT AN APPROPRIATE SCAT.R <br />I/we certify that the proposed construction will conform to the above � <br />plot plan(dimensions and uses) and that no change will be made without <br />first obtaining approval. � <br />i <br />� �.�✓ � <br />„ Appl' - ts �igna• re Approval Date <br />_ . � <br />�': <br />0 <br />