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P;. O m P 7, P, i: <br />OT^INER G/i'o/+/in. /✓���:+�5 _�i2� c� � <br />JOB AD�7RESS ��/� �-' i �� /�/.'i�'cu ��. l= ..— / urv'�=; .� Gli/�r,� <br />LEGAL G'�SCRIPTION: LOT ,_1 ;1 IILOCK OF /y/�, �,,,;; �, �, t/�,�I '�: � <br />Applicant shall complete this form showing all dimensions o� the property <br />structures, and property lines an:- distances between a11 ex:sting and pro- <br />posed structures. Also show location and dimensions of all streets, <br />rights of ways, alleys, puL-lic facili'ties, easements and unc'=_rground <br />util �.ties. <br />INDICA"'E NORTH IN CIRCLE AND SHO[9 ALL STREET.^ AND ALLEYS, <br />PLOT PLAN TO BE DfiAT�IN AT AN APPROPRIATE SCALE <br />I/we certify that the proposed construction will conform to the above <br />plot plan(dimensions and uses) and that no chznge a�ill be made without <br />first obtaining approval. , <br />'� � ; / �� <br />.�i <br />,,��-,.--✓. P -��� /�. <br />- ' P.�Ftlicants signature Approval Date <br />