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at �ltterutile APPLICATION FOR FENCE PERMIT PRINT all information on this application. PERMIT NUMBER: Name:f t Q .,l/n 'SA �l Phone: Day: (AO) / -- ,J Night:( ) - Address: /�$�S p e,9* City: State:42 Zip s% E-mail dress joR/S�//1. 3 ®.9t /1' tdf''1 Location of Property: � Site Address/House No. : ,/ (7 J Legal Description of Property: &e< 7''' d.c/,r1 7 5 Js a �'--0.'A-- e Size of Lot or Parcel: 7�.,e/i9�� Current Zoninjp / Eat.Cost of Protect:S /Q 60, 0 t Type of Construction:(✓Check all that apply.) Wood: 6'or Under: Chain Link: 6' 1"or Over. M (A Separate Building Permit is Needed) Split Rail(Front Yard): 1 Linear Footage Decorative(Front Yard): >North South East 24,West Other , / /f� (Describe):1 lt�.96AK iCt �/1 e —1/-'51-01P •V il Tj 1/s;0'�1l/// AP7i11/ .14/;q4l Footage:_, 406 Contractor: /,D Phone: -----17 License# Anticipated Starting Date: 1 / /_,. _ Estimated Completion Date: / / A sketch drawn to scale must be attached showing;A. Lot lines and corner pins;B. Dimensions of existing buildings and proposed new fence; C. Distances from lot lines and buildings. D.All Easements (Utility and drainage)E. Utility lines entering the property. Corner pins must be established and marked by the owner and visible for inspection. Two copies of construction plans must also be submitted. Property Line Setbacks: Front Setback: . ft. Rear Setback: ft. Looking at the Property from the street: Left Sideline: _ __ft. Right Sideline: ft. Live on a Corner Lot? Work in Right of Way? I hereby declare that I am the owner, or authorized agent of the owner, of the above described property and I agree to construct the fence or use herein described in accordance with the regulations and ordinances that govern said improvement within the City of Centerville and that the foregoing information contained on this application is a true and correct statement of my intentions. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not, The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating fences or construction thereof.I understand that any utility that must be moved as a result of additions or alterations to the property will be at my expense and I will be responsible for the cost of the plan check of this application even though I do not continue the project. I also understand that the City of Centerville is not verifying my property lines,they are only visually inspecting that I have obtained a certificate of survey or have exposed the existing monuments. I agree to be held entirely responsible for the placement of the fence and if in the future it is determined to be in a drainage/utility easement it will be removed at my expense and if in the future it is determ' ed to be on the property line or neighbors property,without proper abutting neighbor approval filed with the City of Cen es shall not impede water drainage/flowage. Signature of Applicant:' Date: /*{ k,/ ************* 4 r_ -tin TO lowing to oe completed by the City) ************************* Fence Permit Approved By: Date:—/ I Fence Permit Denied For: Date: /J Attached Letters From Abutting Property Owners on File with City: Date: / I Date: /J Date: / I TOTAL FEES DUE:$ 60.00