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SCHERULE_B

APPLICATION YOR A PLUMBING PERMIT, TYPE: FIRELIHE/SPRINKLER

APPLICATION DATE:

I/We hereby make application under the provisions of the pertinent Bylaws
for permission to construct, repair or alter the following building or
structure and agree to comply with all the requirements of the said Bylaws
and to indemnify and keep harmless the Municipality against all claims,
liabilities, judgements, costs and expenses of whatever kind, which may in
any way accrue against the said municipality in consequence of, and
incidental to, the granting of the Permit, if issued.

BUILDING SITE ADDRESS:

PARTIAL LEGAL DESCRIPTION:

CHER

Address Address

City City

Postal Code Telephone Postal Code Telephone

No. of Meters/Items

Meters of fireline
Siamese Connection(s)
Fire Hydrant(s)
Sprinkler Head(s)
Hose Cabinet(s)

Hose Outlet(e)
Wet/Dry Outlet(s)
Stand Pipe(s)

ake ee a aw He Every owner shall give at least 48
COFFICKE USE OLY # hours notice to a Building
wPermit No.3 * Inspector pricr to the start of
* * work on the building site.
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*Fee Paid: CHC) CAC
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APPLICANT

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*Receipt: BE Q(_). Bi) At)
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*Comments 3
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awk aaa waa ea ea a we | Telephone

2735

20

Name

Signature

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