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SITE PLAN MUST SHOW ALL PROPERTY LINES AND DIMENSIONS a <br /> ❑ Drawn to Scale: 1 square= Feet Not Drawn to Scale:Total Acres 1 <br /> r- <br /> . . . . . . . . . . . . . . . . . . . . .. •ButADAiNI°G.1\iiNCsupEucloY <br /> SD <br /> � ' <br /> .. .. . . . . . . . . . . . . . <br /> $Acv <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> eNS� <br /> n <br /> 70 . <br /> . . <br /> I certify that the above information is accurate to the best of my knowledge. I AM THE [ Owner ]Authorized Agent <br /> Stephan D P epe 503-756-0185 <br /> Name(please print): i' My telephone number is: <br /> Applicant Signature: Date: O Z —0 7 - Z o 2-2. <br /> Applicant's Mailing Ad ess: //Z31 i'i ,f l cc 5 E. City: L y f tl S Zip: C( I 3 <br /> FOR OFFICE USE ONLY <br /> PLANNING: Date: <br /> PUBLIC WORKS: <br /> BUILDING INSPECTION(Acceptable for Planning requirements only) Date: <br /> A-33D Rev.05/2011,09/2012,2/4/2020 <br /> Page 4 of 5 <br />