Lakewood Estates-CN 940310HOLD HARMLESS AGP~EEMENT
_~/=~JW~. ~ SUBDIVISION ,~//; ~Z F ~~
(~D~SS), cOPPE~, T~ (~ O~ER) ~DERST~D ~
AC~O~EDGE ~T T~ FENCE ~ICH IS LO~TED ON ~IR PROPER~
ENCROAC~S OhiO T~ CI~ OF COPPE~ ' S D~I~GE ~~;
~D
~, ~ 0~ ~E~T~D ~ AC~O~EDGE ~T IN ~E
~PkI~ 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~ ~COGNIZE ~ AC~O~EDGE T~T SUCH FENCE
W~ INSTAIJ.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~, ~ IF O~ F~L TO
~ FENCE ~ON ~Q~ST BY T~ CI~, ~ CI~ W!~ ~MO~ SUCE
FENCE ~D O~RS ~BY I~E~IFY ~D ~OLD ~ CI~ ~ESS FROM
AIJ. C~ OF D~GE TO ~ FENCE ~ICH ~ISE FROM T~ CITY'S
~MOV~ OF SUCH FENCE ~I~ ~P~RING, INSPECTING, I~ROVING OR IN
~ WAY SEEKING ACCESS TO ~ D~I~GE ~E~. ~DITIO~TJ,Y,
O~RS AGUE TO ~I~SE ~ CI~ FOR ~O~LE COSTS INC~D IN
~MOVING ~ FENCE.
owner )
owner )
BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
Subdlvis~on:
Address:
Phase or Section Number:
Contractor=~f~ T~~ Address: ~){
Description of Work to be Done Class of Worl~ ~/Ne~~ I-]Additlon
[] Alteration [] Repair [] Demolition
Area of Building in Square Feet
First Floor Garag~
Second Floor Other
NOTICE
his permit begom~ null and void if work or construction authorized is not commenced
within 180 days, or construction on work is suspended or' ab~ndonad for a period of 180
days at any time after work is commencad.
Zoning District:
I hereby certify that I have read and examined this application and know the same to be true
and correct. All provisions of laws and ordinances governing this type of ~,~rk will be
complied with whethe~ specified her~in or not. The granting of · permit does not presume to
give authority to violate or cano¢l the provisions of any other federal, stato or local law
regulltin~].~struc, tion or the performance of construcion.
Mechanical Contractor
to be Performed
GRAY AREA FOR OFFICE USE ONLY
Receipt Number:
Occupancy Classification:
OD DRIV i::