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APPLICAT <br />ADDRESS <br />LCGAL 1 :CRiPTION: LOT <br />UNPLA^.� 'D: <br />]MOCK ADDITION <br />This fora shall be completed by the applicant showing +'11 dimensions of the property. <br />Show all dimensions of the aL•ructur-an (s) and dimensions to property M;0S. Show all , <br />casements and other public facilitirs located on or within tho•cubject••property. <br />i/wo certify that tbe.proponed construction will confor to tho•submitted plot plan <br />(dimensions'and u::es) and tliat no change will be made without first obtaining approval* <br />Wirt ' APPROVAL DATE <br />