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a <br />P L O T P L AN <br />OWNER <br />JOB ADDRESS <br />LEGAL DESCRIPTION: LOT BLOCK OF <br />Applicant shall complete this form showing all dimensions of the property <br />structures, and.property lines ans distances between all existing and pro- <br />posed structures. Also show location and dimensions of all streets, <br />rights of ways, alleys, public facilities, easements and underground <br />utilities. <br />INDICATE NORTH IN CIRCLE AND SHOW ALL STREETS AND ALLEYS. <br />PLOT PLAN TO BE DRAWN AT AN APPROPRIATE SCALE <br />I/we certify that the proposed construction will conform to the above <br />plot plan (dimensions and uses) ari that no change will be made without <br />first obtaining approval. <br />Appiicants signature Approval Date <br />