ae
Stes
Vy
Lads

ErAe
Pa ee
iY

shiny,

4,
we dey F
athe

ued vayeys Buns ot heey
SMC Laat f vaivbiea dts i : wast

eae

APPLICATION DATES

A:

ty

eT
ee ae,
se Py

UN
;

i, a?
Dorlas

Put? 3

I/We hereby wake application and provide plans under the provisions of the

pertinent Bylawa for permission to construct,

repair or alter the

following building or structure end agree to comply with all the:
requirements of the said Bylaws and to dindeanify and keep harmless the

Municipality against all claims,

liabilities,

judgemante, costs and

expenses of whatever kind, which may in any way accrue agninet the said
mmicipality in consequence of, and incidental to, the grenting of the

Permit, if issued.

BUILDING SITE ADDRESS:

PARTIAL LEGAL DESCRIPTION: Lot #

Plan #

Addresa

City

Postal Code Telephone/Fax

Maters of fireline

Fire Department Connection(a)
Fire Hydrant(s)

Sprinkler Head(s)

Hose Cabinet(s)

Howe Outlet(s)

Wet/Dry Qutlet(e)

Stand Pipe(s)

RAHARRRRANRKR AAR H RH

WONTICE USE GLY
*Parmit No.2

w

*Zoning:
*

*¥ae Paid:
*

Receipt sie
ve

*Comments 3

w
*

%
ARARAHRHAHR HRA HH

CORTRACEY 4

Name

Addreas

City

Postal Code Telephone/Fax

No. of Metera/Itens

We do not plan review at the
counter. Incomplete drawings may
delay your permit application.
Your g@ignature acknowledges your
acceptance of thie policy.

ARELICARE

Nana

Signature

Telephone/Fax

ne

Lae

BAe

SU OnE