I consent to the filing of this site plan with the __________
of the Borough of Wallington.
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Applicant
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Date
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Site plan of
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Lot __________ Block __________ Zone
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Date __________ Scale
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Applicant
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Address
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I hereby certify that I have prepared this site plan and that
all dimensions and information are correct.
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Name
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Title and License Number
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Approved by the _________________________ of the Borough of
Wallington.
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Date
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Chairperson
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I have reviewed this site plan and certify that it meets all
codes and ordinances under my jurisdiction.
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Date
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Engineer
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I hereby certify that all required improvements have been installed
or that a performance guaranty has been posted in accordance with
Section ______ of the Site Plan Ordinance.
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Construction Official
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Engineer
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