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SITE PLAN MUST SHOW ALL PROPERTY LINES AND DIMENSIONS <br /> . ❑ ' Drawn to Scale: 1 square= Feet Not Drawn to Scale: Total Acres <br /> ' 7$ -14/ Ave NE <br /> 937 -73r" Aug ,V ,. <br /> . .b . . �.� .0 I).45 $ . . . . . . . . . . . . . . . . <br /> cv i . t.).5 . AC . . . . . . . . . . . . . . . . . . . . <br /> (11 <br /> NI <br /> N ( . . <br /> /19- <---7-.' --- .... <br /> ct_ <br /> o <br /> . . . . . . . . . N <br /> . . . . . . . . . . . . . . <br /> ▪ . . . r.,,. .. . . . . a Al • fZ t •g.R1'f, <br /> ▪ . -. <br /> ia� . cal. . 1 <br /> x <br /> . . .gyp. . . f <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): My telephone number is: <br /> Applicant Signature: Date: <br /> Applicant's Mailing Address: City: Zip: <br /> FOR OFFICE USE ONLY <br /> PLANNING: Date: <br /> PUBLIC WORKS: <br /> BUILDING INSPECTION(Acceptable for Planning requirements only) Date: <br /> Page 4 of 5 <br /> A-33D <br /> Rev.05/2011,09/2012 <br />