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S <br />P L O T P L A N <br />OWNENJ <br />JOB ADDRESS (j%i/% I/i�iT/. <br />LEGAL_ DESCRIPTION: LOT BLOCK OF <br />Applicant shall complete this form showin4 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, casements and underground <br />utilities. <br />INDICATE NORTH IN CIRCLE AND SHOW -ALL STREETS AND ALLEYS. <br />PLOT PLAN TO BE DRAWN AT AN 1PPROP1iIATE SCALE <br />LZ—F A V E R <br />14 <br />.14 <br />r 5,e'.• yard I i <br />I/we certify that the proposed construction will conform to the above <br />plot plan(dimensions and uses) and that no change will be made without `�A <br />first obt 'ping approval. <br />App iCants sig at-ure Approval Date IN( <br />