Eagle Point-CN 940920HOLD HARMLESS AGREEMENT
~[.~ ~ .. SUBDIVISION, ~/~l ~
(A~6RESS), COPPEI2L, 1~ (~ O~E~) ~DERST~D ~
AC~O~EDGE ~T ~ FENCE ~ICH IS LO~TED ON ~IR PROPER~
ENCRO~S O~0 T~ CI~ OF COPPE~ ' S D~I~GE ~~;
~D
~, ~ O~ ~E~T~ ~ AC~O~EDGE ~T IN ~E
~PAIRS OR I~RO~S ~ ~QUI~D TO BE ~E TO ~ CI~ OF
COPPE~'S D~I~GE ~ ~ICH WO~ ~QUI~ ~MOV~ OF T~
FENCE IN O~ER TO EFFECT SUCH I~RO~NTS; ~D
~, ~ O~E~ ~OGNIZE ~ AC~O~EDGE T~T SUCH FENCE
W~ INST~3.ED DESPITE ~O~DGE OF T~ CI~'S D~I~GE ~E~;
o~Rs ~B~ AGUE T0; ~M0~ SUCH FENCE AT ~IR O~ COST ~D
~ON ~Q~ST B~ T~ CI~ 0F COPPE~, ~ IF O~ F~L TO
~ FENCE ~ON ~Q~ST B~ T~ CI~, ~N CI~ WI~ ~MO~ SUCH
FENCE ~D O~RS ~B~ I~E~IF~ ~ HOLD ~ CI~ ~ESS FROM
~T.L C~ OF D~GE TO ~ FENCE ~ICH ~ISE FROM T~ CITY'S
~MOV~ OF SUCH FENCE ~I~ ~P~RING, INSPECTING, I~ROVING OR Il4
~ WA~ SEEKING ACCESS T0 ~ D~I~GE ~E~- ~DITIO~TJ.~,
O~RS AGUE TO ~I~SE ~ CI~ Fo~~LE COSTS INC~D
DATE
(owner)
BUILDING pER M PPLICATIO
Print or Type in a Clear, Legible Manner
SEP 29 1994
PUBLIC WORKS
J
Phase or Section Number:
Phone #:
Phone#:
Description of Work to be Done
Class of Work: ~/New rlAddltion
[] Alteration [] Repair [] Demolition
Area of Building in Square Feet
First Floor
Second Floor
Garage.
Other
NOTICE
This permit becomes null and void if work or construction authorized is not commenced
within 180 days, or construction on work is suspended or' abandoned for a period of 180
I hereby certify that 1 have read and ex~-,nined this application and know the same to be true
and correct. All provisions of laws and ordinances governing this type of work will be
complied with whcther specified herein or not. The granting of a permit does not presume 1o
give authority to violate or cancel the provisions of any other federal, state or local law
regulating construction or thc performance of consjruction.
FOR OFFICE USE ONLY
J
J
J
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*VERIFY ESMT IN FIELD*
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