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Describe Work:
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AU- UNUNES MUST BE TOCATED PRIOR TO A]IY GRADITIG
lhereþ7ceiüifo ühat å t¡ave read tf¡ùsAppffiaaüor¡ aíld tFlat ti¡e ünfonnetkm mr¡tained above is true and cørnþnrr- I
underffithattfie Buiffirtg Ðûvürlon a@ptsülìeApplication, aloqgwùühttre plans and specifications and6¡ll¡gr
data subrmiltted hy nrc or on rrury hefirallf {olbnnírttalb}, hased upon nry certåfrcation as to accuracy. Assumårg
comdeúmss of tfr¡e zuhn¡ärtüab amd approvaB of ti¡b Appeeaü¡n¡, a BuiHirg Permft win be issued grantirry
permiçsiÛîìb nne, as Oümer, to comdru¡dthe stnuctr¡re(s) a¡¡d faci&ties detailed on the s¡¡bmittals reviwed hgtfre
Buildr¡g Dtii'vfiSm- lr¡ cons¡dsatäon of üÌe ¡csr¡ance of fhe eril&rg Perrmtq" I æree that I and my egents wlf gonnpty
with ptoliä¡un of any fedm'a!, 9a@ or bcd ¡aw reu{an¡¡g the wk a¡rd fte Garfrdd c-ounty Building Oode,, c}trTS
regulatirenro ard applüeabüe land ¡rse rrydhtitn¡s {County Rquht¡sx{s}h I ackroed@e türat the Buildirry knrmfrt
may be suryended or rewked" upon ndfue ftwna ürc f-or¡nty, ¡f üe bcation, ær¡strudion or use of the Snrmûure(s)
and faciliityl(iies), descrihed abora" are r¡ot ir¡ æ¡Mar¡æ wtth County @ulatior{s} or any other applica$Þ lhur"
I herebifi g¡-ant penrnússfrorn b tlrre erileülrry Eüvt$on to emter the property, described abore, to inspect the woilk- ü
furthw adbmw{@e tf¡at tt¡e llssuar¡æ ofitlre Bufldrg Fernnùùt dm rmû prerænt the Buildng Official fronn: ((11)
requiñttgührecomectiomof errorsþntlnestdb¡m{ttab" if any, dccanmrd afterissuanæ; or{2) stopping corffirurfion
or use'dtÍhesilrucüune{s} øfactr[tfrb] ¡if s{rú b ¡nviohixr of Ccmty Rquht¡ods} orany other applidblhrr-
Reviw of ühis nppmaanior¡, indulrg whmûtbk, arnd ¡nspectims of ü¡e worß( bV the Building Division do rmfr
constiüuþanaæpúarDceofresporxSbmrycrFabffiltybyttleCountyoferrorqornåsirnsord¡screpãncies Asülim
Owner; ll adhmuot@e tlnit reryonr$hämty fur æn@fanrce wäth f,ederal" siate ard locd lms and County @dHiorrs
rest witÏrr rne ard rrIY errtfÐrtæd aßeilüs, irmdunfüry wfttlrurt lünnùtatüon rmry arúilect delfuner, engíneer aty$/l wr
builder,
I hereùl*prdedee ffi I h¡E rcd and rmdcrürl üc norice rrd ccrtiñcation above ænr æ
have pnrrirled the ruç¡rcd inûonn*Ìn diú b crcc and m¡r¡te to tlæ bcst of my kno*¡5e
Propert¡7 (bner Prim end Si€n Düe
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Audrclfty. Thb app[iøtibn for a Buriì[dry pemû¡t rã¡T¡st be
an autJhoriiæd agerùt- mthe {gmature beilour b rmt tlllat of
Owner,, rmüs be prors{rted wùd¡ tlffsApdl¡catñorì.
tegalå@¡Ê AB{¡¡å&EPentr¡ttcanr¡otheåso¡edwûttrroutproofoflqgalanda@uateaccesstotheprryfty/for
purp¡qeç off íhspecriexm by ffie Bs¡ükfing Сuår¡on.
Other kmts- hduðtfipüe separab pernniils nnay he neqrrãred: {3.} State Efecfrical knnit, (2) County OWTS k|nmüt,
(3) amtlhnr permnÌt requlrd for uue om tÍrre proparty ideratirfred ahoue, eg- sÌate or County Highway/ Road Aress or
a StateMúffiBvater Diseünarge kmtiL
Void M. A Bttildrq Fermit bemn¡s nu¡M arùd lm*d ffiüle uørk autl¡oriaed b not con¡menced within r*o &¡¡s of
the daüeof iiss¡¡anæasd äf workiss¡ryertddoraher¡dor¡edfora periodof ltr)dryafter commencenìerîü,.
sqryred hy ùlre Owner of the property, describd úme, or
dlre Qwnm" a separate þtter of a uthor¡ty, sþned hy¡ the
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