Devonshire 1-CN 940126HOLD HARMLESS AGREEMENT
/ BLOCK__~_~, OF THE
wt41A~?3~S, TH]~ OWNER OF LOT__~ZO__,
(~D~SS) , COP~,
AC~O~EDGE ~T T~ FENCE ~ICH IS LO~TED ON ~IR PROPER~
ENCRO~ S 0~0 T~ CI~ OF COPPE~ ' S D~I~GE ~~;
~D
~, T~ 0~ ~E~T~D ~ AC~O~EDGE ~T IN ~E
~PAIRS OR I~RO~S ~ ~QUI~D TO BE ~E TO ~ CI~ OF
COPPE~' S D~I~GE
FENCE I~ O~ER TO EFFECT SUCH I~RO~NTS; ~D
~, ~ O~ERS ~COGNIZE ~ AC~O~EDGE T~T SUCH FENCE
W~ INST~ED DESPITE ~O~EDGE OF T~ CI~'S D~I~GE ~E~;
o~RS ~BY AGUE TO ~MO~ SUCH FENCE AT ~IR O~ COST ~D
~ON ~Q~ST BY T~ CI~ OF COPPE~,
~ FENCE ~ON ~Q~ST BT T~ CI~, ~N CI~ WI~ ~MO~ SUCH
FENCE ~D Ow~RS ~BY I~E~IFY ~ HOLD ~ CI~ ~ESS FROM
ALT. C~ OF D~GE TO ~ FENCE ~ICH ~ISE FROM T~ CITT'S
~MOV~ OF SUCH FENCE ~ILE ~p~RING, INSPECTING, I~ROVING OR
~ WAY SEEKING ACCESS TO T~ D~I~GE ~E~. ~DITIO~TJ*Y'
o~RS AGUE TO ~I~SE T~ CI~ FOR ~O~LE COSTS INC~D
~MOVING ~ FENCE
DATE 2 ·
14.00~
BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manne.r~ .
Lot: ~) Block:
Contractor: ~&
Description of Work to be Done
xA ess: ~ .~
Class of Work: ~New ~Addition
! PUOL, WOR $
Phase or Section Number:
[] Alteration [] Repair
[] Demolition
Area of Building in Square Feet
First Floor
Second Floor
Garage
Value of Work
to P ao, .d
GRAY AREA FOR OFFICE USE ONLY
NOTICE
Tills permit becomes null and void if work or ¢onsUmction authorized is not commenced
within 180 days, or construction on work is suspended or abandoned for a period of 180
days at any tkne after work is commenced.
I hereby certify that I have read and examined this application and knoTM the same to be true
and correct, All provisions of laws and ordinances governing this type of work will be
complied with whether specified herein or not The granting of a permit does nol presume to
give authority to violate or cancel the provisions of any other federal, state or local law
regulating construction or the performance of construction.
Permit Fee:
Receipt Number:
Zoning District:
Approved By:
Comments:
Occupancy Classification:
Date: