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P L 0 T P L n N <br />OI•7�1PR <br />J013 ADDRI:SS , <br />7�EGAL DP:SCRIPTION: LOT •, " IIT OCK � OF <br />App].icznL- �hall complete tltis L-orm St10lJlllCj a]1,dimensi.ons o` tlte ^rope;: t7 <br />str.uctur.es, and property li.nes ans d.isL•ances bet�.acen a1.1 e;;isting and nr.o- <br />nosed �L-ructurc,. I�l.so sho�i location and dimensions of all strcc;:s, <br />rights of: e:ays, al.leys, pub..ic faciJ.ities, casements and ttndr_r.�rounci <br />utiliL-i.es. • <br />INDICA'.`,'E t�IORTIi IN CIP.CI,E AND SIIGf•1 ALL STltiii:TS A2dD �II.�P,YS. <br />b' <br />PLO'P PLAid TO BE DRANN AT APT APPiZOPRl`ATE SCAI�E <br />i/we ccr.Li.f'y L•hat_ Che propo::cd consLri.tction P:11.1. rontrim Co the r:i,ovc <br />n.LoL- p.L.in(dimen:ions and use�) nnd L•]iaL• no chringe t•�i.11 be made �::;.��ouL- <br />1'..irsL- oLC.lini�tg approval. <br />� _ ... - �cc. -.—V l `>� 1----Z --------' <br />A?L�].tcanC:; s.tynaL•tu:e I�pproval DaL-e <br />.� 6 ,i�.. <br />