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Ot4NER �.Q I^ !? E N�i H. <br />JOB ADDRESS I�C �7 M c <br />P L 0 T P L 1� N <br />U_<44Y <br />. ..e <br />LEGAL DrSCR].PTION: li0T_ S I3LOCK 3� L OP Pc4t cF �-v1=n�rr ryi�is�c,� P _ <br />Apnlicant �i�all con;plete this fonn sho���inR all. dimensions of the properCy <br />str.ucCures, and prop�ri:y l.i.nes ans distances Uetwcen all existing ru�d pro- <br />oosed structures. Al.so show locati.on and dimensi.ons of al ]. si:reets, <br />r.i.qt;ts of �•r<ays, all.cys, pt�Ulic faciliti.es, easements ruld uncicrgrowtd <br />util.iti.es. <br />� <br />I1dDICA'CL NORTH IN C�P.CLi; P.'9C SIIOF: i+LI� ST32EE'iS nl�i) lLL1:YS. <br />PLOT PLAI4 'PO IIE DRI�PdN AT AN APPROPRIAT.r SCAI.I• <br />---. ___. . .. ._ . f t..n / <br />z <br />4 <br />� <br />V� <br />n� <br />I/we certify that the proposed construction �vil]. conform to the �bov� <br />plot plan(dimcnsion; and uses) and that no change ��ill bc iaadc w3.thout <br />first oUtaining ��ppro�zal. <br />�i ��� <br />__� /� — — A>>roval Datc -- <br />A;�1�].ic�nt:: signattu:e Il <br />