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OWNER <br />JOB ADDRESS <br />LEGAL DESCRIPTION <br />P L O T P L A N <br />m <br />LOT_ IILOCKUr�� «� <br />CW <br />Applicant shall complete this form showing 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, easements and underground <br />utilitijes. <br />INDICATE NORTH IN CIRCLE AND SHOW ALL STREETS <br />PLOT PLAN TO BE DRAWN AT AN APPROPRIATE SCALE <br />ALLEYS. <br />I/we certify that the proposed construction willconform to the above <br />plot plan(di.mensions and uses) and that no change will be made without <br />first obtaining pproval. <br />�— <br />A rovai Date <br />Ap li�ts signature pP <br />