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. , U •Drawn to Scale: 1 square,_-.-s- Feet Not Drawn to Scale:Total Acres /2 We <br /> . . . . . . . • -- • ' -EA 57- <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> • , . . . . . . . . . . . . . . . - • • • <br /> . . . • <br /> . . . . . . . . . . . . . . . . . .. . .. . . -• <br /> . . . . . . . . . . . . . . . . . .. . . . . <br /> . <br /> - 0:945111 ,B\ . . . . . . . . . . ', . • • • <br /> ' • 'F-MIL,,,,.., ":7-1 <br /> .w.._11 11 <br /> 1 <br /> A10 ST1--1 1 PR 04051 1 ( <br /> . GDIXTI-1 <br /> ,---. . • , <br /> DIW ELL. <br /> " • • - •. . . 3 \, <br /> . . .' ' ,. . . ,_ . . . . . . . . . . <br /> il 6 <br /> . . .\ :,1/4. . . . . <br /> . . . ' . . - • rAgPA - . . . . . . . . . . . <br /> ‘ viaLt, <br /> _........:3 04. <br /> . . . . . . . . . . <br /> \ \ ive.. . . . . . . . . . <br /> • • . - • • f \ ', . . . . . . . . . <br /> - . . ' - VIR 'fiv6 <br /> . . . . . . Lew . . A - -.,, ,-. -. . . . . . . . . . . . <br /> . . . ...-:r .----...-....013. i. tri ; 1 . . . . . . . . . <br /> ...„, ,,,, <br /> ,.. vua---5.--r- <br /> I certify that the above information is accurate to the best of my knowledge. I AM THE p.<1 Owner [ I Authorized Agent <br /> Name(please print): 1--)- V:ir <br /> .) F1k01-0 V My telephone number is:.563-SOO-039.3 <br /> Applicant Signatur - adre --re'-' ),-.2 <br /> c I <br /> Date: (.0 12 -zoz.3 <br /> Applicant's Mailing Address:7/0 q NWY 2 Jcy _City: (;F-Rimis Zip: (6) <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 />