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o -j <br /> "4,, SITE PLAN MUST SHOW ALL PROPERTY LINES AND DIMENSIONS <br /> ❑ Drawn to Scale: 1 square= Feet Not Drawn to Scale:Total Acres 17.,5 <br /> / <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . ii . . <br /> iprfo5a1re <br /> . - . <br /> 3.o x36 i ' <br /> ce <br /> -\\''.44 <br /> Pl 1 <br /> 1 �• <br /> NI <br /> / . .. <br /> to <br /> _ _ <br /> r <br /> I certify that the above information is accurate to the best of my knowledge. I AM THE Owner([ .]Authorized Agent <br /> Name(please print): bell ' +- lilena � 16' My telephone number is: C6v3) V aL-2Jd 0& <br /> Applicant Signature: w�A Date: 11.0 23 • <br /> Applicant's Mailing Address:: ?-O. 11.i(/y) 70 I City: 8tht UYV Zip: 61 73g) <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 />