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SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT <br /> Site Address: L.5$�1 & -Sc ef' LPN S6-)5 bkInt•k1 t / CI13g5 <br /> Township Range Section Tax Lot OM£30 O)tQ lTotal Acres 2l <br /> Subdivision Block Lot <br /> ❑ Drawn to Scale: •❑ Not Drawn to Scale -OR- 1 square= feet <br /> Sex_ )fi4it.rAftif <br /> I certify that the above information is accurate to the best of my knowledge.I AM 1'HI,t>f Owner or[ ]Authorized Agent. <br /> NAME(please print): �►QI►1Q� 1,)z,vVe_r Telephone# S-03—5 o$—$9 S 3 <br /> Applicant's Signature: tf'et Date: V}/I)16) <br /> Applicant's Mailing Address: 15 g 1 G- 5SG l 5�bti vw.k'`\ DR. ct-1 3a c <br /> City: SU itt t-i � Zip: 0 7 3 5 S Applicant's email: ck ci WPA--e-f MA 11. Co Pr.- <br /> S-31-1-2017 <br /> nS-31-1-2017 <br />