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c - .- <br /> SITE PLAN MUST SHOW ALL PROPERTY LINES AND DIMENSIONS <br /> Cl Drawn to Scale: 1 square= Feet Not Drawn to Scale:Total Acres <br /> 1 <br /> . . . . . . . . 1 . ./j. . . . . . . M.... . . . . . . . . . <br /> 4 <br /> ......) il. • . _ . . . . . . . . <br /> • . . . . . • . <br /> . . . . . . • . • • v <br /> • • . . . . . . . . . . . . . <br /> ... <br /> . . . . . . <br /> . ,... <br /> . . . . . . . . . . <br /> ,. .; .. . . . . . . . . . . . . . . . <br /> . . . . . e1' <br /> Ar 1.4 <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): 3-e jI?j l/ /�° My telephone number is: 03-...7S7t7 666. <br /> Applicant Signature: Date: / - .26- /9 <br /> Applicant's Mailing ess: City: Zip: <br /> FOR OFFICE USE ONLY <br /> PLANNING: Date: <br /> PUBLIC WORKS: <br /> BUILDING INSPECTION(Acceptable for Planning requirements only) Date: <br /> Page 4of5 <br /> A-33D <br /> Rev.05/2011,09/2012 <br />