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F L O T P L� N <br />L /'%/ � «/ <br />JOII ADDRESS <br />LEGAI. DESCRII7.`ION: LOT p�� IILOCK OP � n ��Q }Nr�-ow� ��_,_ <br />APplicant si1� .] compleL-e this form showing all dimensions or thc pr.operty <br />structures, and Property lines ans distances bei:ween al.l existing and nro- <br />posec7 structures. Also shrna location and dimensions of all streets, <br />r.iGhts of: ways, alleys, publi.c f:aci].ities, eusements an3 wlderground <br />utilities. <br />INDICATE NORTII Il�: CT12..LL A14:� SIIOP] •l.LL STI2L•'rTS AND ALLrYS. <br />PLOT PLAN TO I3P DP��GDI AT 71N I�PPROPRII'1'.r SCi�L� <br />I/�ae certify tliat the proposed constr.uc�ion �ai.11 conform to the above <br />� p1ot. plan(dimensions and uses) and that no chang� c�i.11 be made t•:ii:houi: <br />y first obtaining approval. <br />� � <br />������-�- ---- - <br />7�?p].icants signai:ure T:ppro��al Date <br />c <br />