Laserfiche WebLink
. - SITE PLAN MUST SHOW ALL PROPERTY LINES AND DIMENSIONS <br /> ❑ Drawn to Scale: 1 square= Feet Not Drawn to Scale:Total Acres (0 <br /> fv. . <br /> ‘,.„ <br /> n <br /> • nr,u, <br /> <, <br /> . . . . . . . . . . . . . . . . .' <br /> . . . . . <br /> . . . . . . E..z:2? . . . es.e,,,,,s-le,\ <br /> '#. • • • 6.°4•Y I . . . . . . . . . . . <br /> ...,,, <br /> \ \..., <br /> ./. . . . . . . I.6N. . . . 4'i- . . . . . . . LiGo- i\ <br /> f - <br /> t <br /> I certify that the above information is accurate to the best of my knowledge. I AM THE [v ] Owner [ ]Authorized Agent <br /> Name(pleaseprint): {{a 6O \ ZSO\ <br /> ��l �S�U�J� 1 / ��'�1��+11� My telephone number is: <br /> qLA <br /> Applicant Signature: � Date: 7— ' 2-2— <br /> Applicant's Mailing Address: 7 6 6 t i 7. '^-AVe NE 'fr. City: S Alter Zip: cAl-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 />