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................. i" .~...""~'"'"' <br /> <br /> Sca]e: I <br /> Drswn By: <br /> I ~ ~at ~e ~ve ~fo~a~on is acc~te to ~e ~s~ of my ~owl~ge. <br /> App]ic~t ~I~ ~t) <br /> <br /> FOR OFFICE USE ONLY <br /> <br /> PUBLIC WO~S: Da~: <br /> <br /> BUILD~G ~S~ON: Dam: <br /> <br />MC: )5-60 <br />Rev. 11/91 <br /> <br /> <br />