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SITE PLAN MUST SHOW ALL PROPERTY LINES AND DIMENSIONS <br /> o Drawn to Scale: 1 square= Feet Not Drawn to Scale:Total Acres <br /> j. <br /> i <br /> I i' <br /> 1 <br /> >> 84 <br /> ' i <br /> (1 �� dtl, <br /> '"�7'`t i i Grp' <br /> • <br /> • 6+141 ShAli� � , . . . . 4 �: ; - <br /> a.- qty. . ,/ <br /> i It ._ ..— <br /> ii:i 411 ,7 ' .W . <br /> . IV,ot4-.1. I (. 1 .0cieo 8 1,—.• • i • • " ., k ' , 1 S , <br /> 1 roe,.I. 4 • t; •F4o . i I Vlifr <br /> I certify ti <br /> r� <br /> that the above information is accurate toknowledge. � Owner thehebcstafm <br /> � I AM TIM(l Oa ncr or s(Authorized Agent NAME - <br /> I (please, <br /> print): Michael J.Paluska,PC Telephone#(503)585-2065 <br /> Applicant's Signature: Date: <br /> Applicant's Mailing Address:1820 Commercial Street S.E. City: OR Zip: 97302 <br /> FOR OFFICE USE ONLY <br /> PLANNING: <br /> Date: <br /> PUBLIC WORKS: Date: <br /> BUILDING INSPECTION(Acceptable for Planning requirements only) Date: <br />