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0 <br />. <br />Oi�NER <br />�OII ADDRESS <br />LEG11L DESCRIPTION: LOT <br />P L O T P L A N <br />IILOCK OP' <br />Arplicant shall complete this form shocain'g ail dimensions of the prouerty <br />structures, and p�'operty lines ans disi:ances between all exisL-ing and pro <br />posed structures. Also show location and dimens-ions of a'l1 streets, <br />rights of ways, alleys, public facilities, easements and underground <br />uti.lities. <br />INDICA'.PE NORTH IN CIRCL� AND SH0�9•ALL STRFETS I�PID 11LLfiYS. <br />PLOT PLAN TO IIE DRA�VN AT AN APPROPR.IATE SCALE <br />I/�de certify that t-he proposea consczuc����� ��.«� ��••��-••• -•• — <br />plot plan(dimensions and uses) and L-hat no change will Ue rnadc 4rithout <br />first obtaininq approval. . <br />— A;�plzcants signature Approval Date <br />0 <br />