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<br /> .. ISU71.Dllll: 1'I:I;!i ['I' T�IPOI;I111'I'Y�1!I
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<br /> (A) Pl,lil C!?LCI: ).'IiI: $ /Fi �, t, �
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<br /> • PEIZ•1IT IS I�SUl:1) ' . $ � �'� .
<br /> (A) TO IIE DLTERI�II:iED �Y PLBG. It•1SP. INCIi .
<br /> {ill �Y.IST._ • i'711TIiR S�P.VTCE, �1PPL. N0. •
<br /> (C) APPP.OX. LOCnTIOt7 [r '' '' ' , �
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<br /> .. . L:� (`F` �l �`.i i %���� , .iifi. , CIIART j-� �L �IL; . .
<br /> ) 1)t?IV�'1CI,`,YC P?Ti.^C.;iITTTO II� Yi�IDL rtL'�ii:ORE ,P[.UIL1DIT?�;r t 1�
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<br /> ) s�;,�oS Ol' SEI7L•'R CI]AI:GES: , TOTAL $ � //. �, a �
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<br /> 33D:�D ��L DTST:tTCi �G r . FOOTAGF. "
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<br /> • YEAR �� 792Ut::: $ ':;. �Q, Q U
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<br /> � 2'OTAL C "I'7rCTI0,J ClI�l1:Gf:$ !J '�� . L�' ;J •
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<br /> Sli!91i1: C0:75'!'P.UC'PIOId: � TRUNN • $ �,! ,
<br /> . •7,A7'JiRAL $ ' '� `_
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