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P L O T P L A N <br />OWNER <br />JOB ADDRESS <br />LEGAL DESCRIPTION: LOT rBLOCR /3 ^ OF <br />Applicant shall complete this form showing all dimensions of the property <br />structures, and property lines ans distances bitween 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 />BLOT PLAN TO BE DRAWN AT AN APPROPRIA'E SCALE <br />4 <br />• • 1��iI <br />`I <br />1 V '?LR31C. Al(Ey <br />N I/we certify ti:at the proposed construction will conform to the above <br />plot plan(dimensions and uses) and that no change will be made without <br />N" first obtaining approval. <br />Atpficants signature Approval Date <br />