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SITE PLAN FOR PROPOSED <br /> <br />PropcrtyOwncr,,~Oq£PT £~ V~I~,~/E /,c/,~L~-'~(,'~ TaxAccount#:~0 <br />Situs Address: <br /> <br />Lou I <br /> <br />Block: _~ Subdivision:~ NO. Acre. s: <br /> <br />M~p:a9 ~W 17 <br /> <br /> Range: <br /> <br />Scale: /" ~ "/0' DrawnBy: /~O~Y£RT <br /> <br />I ce~if7 that fit& above information is accumm to the best of my knowledge. <br /> <br />Applicant'sSignatu~e: .Y~Y~f~d'~/~/. /~}~/Y <br /> FOR OFFICE. USE. ONLY <br />PLANNING: <br /> <br />PUBLIC WORKS: <br /> <br />BI.m r~INO INSPECTION: <br /> <br /> <br />