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SCHEDULE C

APPLICATION FORM FOR A BUILDING MOVING PERMIT

APPLICATION DATE:

t/We hereby make application under the provisions of the pertinent Bylaws for
permission to move the following building and agree to all the requirements of
the said Bylaws in force in the Municipality 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 this

Parmit, if issued.

BUXLDING SITE ADDRESS (moved from):
PARTIAL LEGAL DESCRIPTION: Lot #
BUILDING SITE ADDRESS (moved to)
PARTIAL LEGAL DESCRIPTION: Lot #

TYPE OF CONSTRUCTION Floor area
CATER COPTRAGTOR

Name Name

Address Address

City City

Postal Code Telephone Postal Code Telephone

Assessed Value of Building Use of Proposed Building:

& Residential
Commercial

Specify All Existing Buildings on Lot Industrial
Institutional,

Occupancy Use: (specify)

ee

ANOFEICE USE CHLY
Permit No.?t
w
“Zoning:
*

AFee Paid: CH(_) CAL
*

*Receipt: Bt Of) BY Ad
*

4Comments?
“

Every owner shall give at least 48
hours notice to a Building Inepector
prior to the start of work on the

building site.

APPLICANT

Name

Signature

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