Waters Edge P2-CN 940303HOLD HA_RMLESS AGREEMENT
WHEO~ac TH~ OWNER OF LOT ~/ .-; ~_~LOC~, OF THE
s,. D VIS O , _
(~D~SS) , COPPE~, '1'~ [-~ ~...._R, ~IR PROPER~
AC~O~EDGE ~T ~ FENCE ~ICH IS LO~TED ON
ENCRO~S O~0 T~ CI~ OF COPPE~ ' S D~I~GE ~;
~D
~, ~ O~ ~E~T~D ~ AC~O~EDGE ~T IN ~E
~p~ OR I~RO~S ~ ~QUI~D TO BE ~E TO ~ CI~ OF
COPPE~'S D~I~GE ~ ~ICH WO~ ~QUI~ ~MOV~ OF
FENCE IN O~ER TO EFFECT SUCH I~RO~NTS; ~D
~, ~ 0~ ~COGNIZE ~ AC~O~EDGE T~T SUCH FENCE
W~ INST~T'T'RD DESPITE ~o~DGE OF T~ CI~'S D~I~GE ~E~;
0~ ~BY AGUE TO ~MO~ SUCH FENCE AT ~IR O~ COST ~D
~ON ~Q~ST BY ~ CI~ OF COPPE~, ~ IF O~ F~L TO
~ FENCE ~ON ~Q~ST BY T~ CI~, ~N CI~ WI~ ~MO~ SUCH
FENCE ~D O~RS ~BY I~E~IFY ~ HOLD ~ CI~ ~SS FROM
~ C~ OF D~GE TO ~ FENCE ~ICH ~ISE FROM T~ CI~'S
~MO~ 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
DATE 3- 5~ (o~e~)
( owner )
Owner: ~ ~ Phone #:
Contractor: .-~ ¢'~ -,-' --~,. Addre~.' ~ C~(~,.~ ~' C~ ~. ~
~ ' ~ Cla~ of ~ ~Ad~tion ~ Alteration
~fiption of Work to ~ ~ne
nner i .... WORKS
[] Repair [] Demolition
Area of Building in Square Feet
First Floor_ Garage.
Second Floor_ Other
NOTICE
This permit becomes null and void if work or consh-uction authorized ia not commenced
within 180 days, or consh'uction on work is suspended or' abandoned for a period of 180
days at any time after work is commenced.
App
Comments:
to be Performed
GRAY AREA FOR OFFICE USE ONLY
Receipt Number: '
Occupancy Classification:
Date: -~ , ;;
Signature of Contraclor or Authorized Agent
Electrical Contracto~ Plumbing Contractor