Stonemeade-CN 940125 HOLD HARMLESS AGREEMENT
~D~SS'), CoF~f__'"Tj..~-~iCH IS LO~TED ON ~IR PK~[~5~.__'
~, ~ 0~ ~E~T~ ~ A~O~EDGE ~T IN ~E
~p~ OR I~RO~S ~ ~QUI~D TO BE ~E TO ~ CI~ OF
COPPE~'S D~I~GE ~ ~I~ WO~ ~QUI~ ~MOV~ OF
FENCE IN O~ER TO EFFECT SUCH I~RO~S; ~D
~, ~ O~ ~COGNIZE ~ AC~O~DGE ~T SUCH FENCE
W~ INST~vJ'ED DESPITE ~o~DGE OF ~ CI~'S D~I~GE ~E~;
O~ ~B~ AGUE TO ~MO~ SUCH FENCE AT ~IR O~ COST ~
~ON ~Q~ST B~ ~ CI~ OF COPPE~, ~ IF O~ F~L TO
~ FENCE ~ON ~Q~ST B~ ~ CI~, ~N CI~ WI~ ~O~ SUCH
FENCE ~D 0~ ~B? I~E~I~ ~ HOLD ~ CI~ ~SS FROM
~ C~ OF D~GE TO ~ FENCE ~I~ ~ISE FROM ~ CITY'S
~MO~ OF SUCH FENCE ~I~ ~P~RING, INSPECTING, I~ROVING OR IN
~ WA~ SEEKING ACCESS TO ~ D~I~GE ~~' ~DITIO~V'T'~'
O~ AGUE TO ~I~E ~ CI~ FOR ~O~LE COSTS INC~D IN
~MO~NG ~ FENCE.
~er)
( owner )
Job Addr~s:
Lot:
Owner:
Contractor:
Block:
to be I Class of~
/
BUILDING PERMIT APPLIC
t or in a Clear, Legible Manner
ION
JAN 2, 6 1994
Address:
Section Number:
[-]Addition
Phone #:
Phone #:
Alteration [] Repair [] Demolition
Area of Building in Square Feet
First Floor Garage.
Second Floor Other
NOTICE Permit Fee:
This permit becomes null and void if work or construction authorized is not commenc~
within 180 days, or construction on work is suspended or' abandoned for a period of 180 Zoning District:
days at any time after work is commenced.
I hereby certify that I have read and examined this application and know the same to be frae
and correct. All provisions of laws and ordinances governing this type of work will be
compiled with whether specified herein [ not. The granting of a permit does not presume to Comments:
~ve authority to violate or ~ny other federal, 8tare or local law
or the
Electrical Contractor
Agent Print Name
Plumbing Contractor
Value of Work ...~.~ ~._
to be Pefformedj,~_=J./~.
GRAy AREA FOR OFFICE USE ONLY
Receipt Number:
Occupancy Classification:
Date:
Mechanical Contractor
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