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� <br />P L 0 T P L A N <br />� . <br />O4TidP•.R ,( � � � � �� ' <br />JOB ADDI2ESS ,_ > :� i:.","� �) ` ` � � ' ' ` <br />LEGAL DEuC12IP'PIC:d: LOT�7ir,�� BLOCK /<' OP r� ��i.7;;�nL p�a%� "1'i'�I'.'�: i. • <br />F�C�/�/� i�' ��r� �)La,l F'.- �.� rL - /1' S �:�'�n.-As <br />_ � <br />. ,'i,�.,-o. �i . „�.�i�;. tc-.);;,,.,� �r��.,� � . ------- <br />T+;�plicant sha11 complete this form stiowing all dimensions of the property <br />structures, and property lines ans distances betwc�en all c:tisting ancl pro— <br />posed struct-ures. Also sho�a locati�n and dimensions of all. streeLs, ' <br />ri?iits of ways, alleys, public facilities, easetnents and underground <br />utilities. ' � � <br />!� INDICelTi: I:OP.TH ZN CIRCLE AND SI:Oi�7 ALL ST?iF'PS e1?:D ALI,PY>. <br />N . <br />PLOT PLnN TO BE DF2AL•7N AT I�N I�PPRODRIt1TE SCl�LE <br />_ t , _ -,,,; <br />7/c.•� certify that the pmpn,^d cor.=tructi-un �:ill coniorm to the above <br />plot pl an (dimensions and us��_s? ❑n-: that no c}�ir:nr��� �:�i.] 1 h� m��de �oithout <br />first obtaining approval, <br />, <br />�� Appl�ican�L-s signature Approva]. Datc <br />� . <br />� , . <br />