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APPLICATION FOR FENCE PERMIT PRINT all information o this application. F :,: Dome- res y> 1 593-131 Night: Address; itlre ' tttcc dip; Location of Property: Site Address/Hours;No. Legal Description of � Sire of Lot or Parech CAUTent x f r. _m.._m...........................Est.Cost of Project: n IType ofConstruction: all that 1 e or Under,- Chain nd• m1 Wood: f Link- ' 1"or Over: [ff(A Separate Building Permit is -split Ei (Front ); Linear Footage Decorative(From Yard): North —South __..East West Other(formidb5 eb FOCAW c% / Phone: License Anticipated n Date: Estimated Completion ata_I_/ sketch drawn to scale must he a shod sho ' 111 A.Lot lines and corner pins;B.Dimensions of existing buildings d proposed new fence; ,Distances from lot lines and buildings. .All Easements(Utility drainage)age) .Utility lines enteringthe Career pins must be established and marked by the owner and visiblefor inspection. copies f construction plans l submitted. Property Line Setbacks: Front the fl, Rear Setbacla los it. -------------- Looking at the Property fro the street, Telt Sideline: / i id lists . Live art a o Work in Might of q I hereby declare that I am the owner,or authorized agent of the ram �of R ° I =to construct or we herein described in t tlt�w with s and andsarvas t govern said improvement °hin the City of Centerville and that the foregoing infismatian contained on this application is a am and convot statement of my finonfiess. All provisionsoflaws and ordinanow governing &a type of ill be complied with whether specified herein or not. The graming of a permit does not presurse to give auffority to violate€r carcel the provisions sof any other state or local law regatsfing Fence or construction dsocof f understand that any utility t must be moved a cook of addiflons or alterations to the property will be at my expense and I will be responsiblefor the east of the plan check of Due application en though I do not continue the project. I also understand that the City of Centerville is not verifying property lines,they are only courtly inspecting that I have obtained i ate of survey or have crossed the sending earomments. I agree to be hold entirely responsible for the placement of the fend and if in the future it is deterndeed to be a drainnefnt!Uty easement It will be removedt my largesse d if in the totem it is determined to be on the property line or neighbors property,without proper abutting i hl r approval Ifiled with the City of Centerville it will she be removed at my sources. Fessuo cash,not Boodle water draimgtfflowage. Signature of Applicant: UAW-�n DonewHr - 1 H lowing to be completed by the City) Fence Permit Approved By, ---- � Date: f 1 Fence Fait Denied For Attached Lefters From Abuffing Property Owners on File rem City. .............._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._. Vii ;---_--__ ------" � Core- TOTAL ore- T ` i,FEES $--10.00 i 29