SITE PLAN

Draw a site plan in the space provided below, or attach one as a separate sheet.� Include the following information:

1. Show existing property lines, driveways, alleys, sidewalks, streets and buildings with all lot and building dimensions.
2. Show the location of the proposed new structures, and distances from lot lines to the structures.
3. Show the size dimensions of the proposed new structures, including overall height.
Show the location of utility lines and services, the location of easements and the septic field (if on a septic system).

I certify that:

1. The information in this application is true and correct;

2. The improvements shall be installed or constructed only on property that I own or control; and

3. Any improvements installed or constructed over a recorded utility or drainage easement, whether or not authorized by a permit, is undertaken at the risk of the owner of the property, and that in the event access to such easement is required the improvements authorized by this permit may be removed at the expense of the owner.

__________________________����������� ___________________________________________��������� ___________________________

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