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Clef6dWorlc Rermode#,Alteratiom Addition
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Adrodttr-thb affiilcafiorn for a &ulndireg Fenrmft rmunst he sfrgn€d ry dhe (}umer of the poperuy, descnibed above,
or am arqthor[zed ryenL ffi the semaelre hdw ds notdtat of dre Owrnen, asqara@ lkttryof au&oriity" skned hV
dtle &uner, rmu* be pov{ded wiffir tfrfrs App$iaatt@r"Ld Aoese" A Buildng Fewmit canmot he iseued witftout proof of legal arnd adequate acarss ito the property fior
purposes of inspecnioms h'y the Buildirag Dfofrstom-
other Feryti:rr ilfiuntiple separate pefr{xfrts r!!ay be nequircd: (L} state ffeclyfrcall pomltit" (2} coumty @wT5 Fenmi[
(3) anotheir penrnit neqrrrined for rrce om tfte property idernt!ffied ahonae, e..g- State onc-ounnry frllg[away/ Road Acoess
or a Stalte Wastsrat€r Dfucharge Perrrnit,
Vo*l Ferrnit. A tsuilldirg Fer*rnit beconrrm nulfl arod voird if tfine wnk aqrtfinoriized b mot mnnmernoed withln trg$ days
of tfte date of bsualre and if work [s surspeinded on ahasrdoraed for a perii,od of 1t80 dry after €odnmem6grmenL
{ her@ certfrfu that I have nead this App{rciru..orri amdtftiat tfne iirlfosmatiorn oorntaiirrned ahonre iistru.uearnd coirrect- B
understamd tftnat the Ea.llldirg Dtvfr$ton a@epts filne App{icdt*on, alkomg tmit]h dne pllams annd specirfrrcatfurnrs antd otfien data
suhmitted @ rme or om nny helaallf (slrlbrmfmah], hased uporn mrrry centfrfrlcatjiorn as to a@uraay.. Assu11na6nrg oinrrfretenessdfu $uhnnitta[s arnd apprwal of mhis Ap$frcmfonr, a EuiilHlinry Fernnfrt wffllll he irssured gnarntirry pennnjiss&om to fiie,, as
@vuneqto rcnrdrurctt{rc stni€hrre(s} annd facjllfeiresddaiilled om tllnesuhrnrfttalls rrevjiemoed hVdlre Buriifi6irng Dfiv51ior1- tn
mrnsfrdeirationr of tline iiss{Iarnr.e cf tllae Buuiilldiirng Fennraii[ $ agrree tllirat I arnd nrnry agenrts wii1{l mnnffi wfrdh prcvrisirorns of arny
feder-all" stdte orr llocaU llaw regruflatimg tltae woirlk arnd tllrc GarfrieM Qculmty B{uiildfirflg ao@, OWTS rrqrr.ullatflons arnd
apflhcah{e llarnd u.lse negruflatiloms (e{rm'ty Regdhtironr(s))" FUlfi courmty devrdhprmrernt nequrlining a penmfrq" egept fCIr
resll'deintiafi uses, are *lb@t to Antfrc]le 7 d tfne l.anrd {,Jse anrd nevellopmernt code- 0 adkfllo,wj|e&e thdt dre Etrd[diw
Fenr,nii[ rmay be surspenrded on revolked,, urporn rnotiae frronn t{ne fuLqmty, iif tfne llocatiiornr, mnrffirxttjionl on urse of the
struuctun{s} amd faciflfrty(iies}, descnfbed ahoue are n@t irx c@mnplliiannce witltr Couunrty ntegulhior(s} or any otfrcn
appllicaMe llaw-
[ lnerefuV graffa pernnniissiiorn to tfrne trr.uilldnrg Diivisfoo to enrter tJlne prclperfy, desCriihed ahove, to iirnspect thne uror*r- I
frurdher adkmowlle@e #rrat dhe issuranrce ofi trlie Eu.liilldrng Pennni[ d@es nd peueft tllne tsrriflldiirng @frcia[ fronm: (1] req*irrimg
the correctiorm oF enrons frnn tfne srr.lhrnrniitttalls, If any, diisoorerred after lssruarnce; on (2] srtqppiinrrg aa1fi6trudtfom on use of 6he
sOructu@s) or facdifMi6) if sudh [s lrnr vilo{atioan of A-our$ty Regllllatfon(s} on airny 666rer appllircable llaw- Rwiiw of tlaiis
Appllilcatiora, iirrdrudiinng su.uhrrmflttalls, arnd rr-rnrspectfums ddtne w,orlk by ilh€ tsu,uilfidiirng DiMisiiom do md @msftitute am
acceptarnce of respornsn'hiillfrty on lllahillity @ drc &uilrty of edrons, ormiss&ornrs oir disoreparnoles- As tJhe Otn meq I
relhcrwile@e dtmt respomsihillityfor mnnrplliiame witfn feden-alf *ate arnd 1ocall 1agas arnd Cor.urnff Reg{rl1gtrf,odns nest wftftr
nne amd nmy aeutllwrlzed 4ernts, firncliudilry wiitltnout lliirnrnFtatbrnr rmy arcllniiteat desi€fier;, engfrmggrr annd/or hruillder-
I ts€by aAsputl@e ftet I frrye rcad and ucdersffrrll fte FN@ii@ and f.erdficrtim ahorrc, e we$ as, lrru
prodded the required infonroarion wfri$ h coryect srd accurab b fte best @f rilf lsrwlefte.
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