2012-01055 - pool - in ground - Laserfiche WebLink

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10/3�/2�12 04:17 9529855323 QUALITY POOLS PAGE 03/93 . REQUIRED SUBMIITALS: � AA of the ir�fomlation must be submitted in order for our application to be rocessed: .. .. . . . .; . . �.. . . .;, - . �.: ...,. .,.. . . .��...� �.; � . . .. � � ....�..�.�.:., . .��. :� . . . . . . . '� .. �•�Etfclbs:�ed��;��....;• :.A .Iicable:: �..•. � �.� . ' . . .. . , : . , , , : . . . , . . � ❑ Permit lication 0 ❑ Plan Review Fee ❑ ❑ Pool Plans o ❑ Surve includes radin lan ❑ ❑ Hardcover Calculation WoMcsheets ❑ 0 Erosion Control Plan or co of MCWD Permit O O Se tic S stem Certification � � � We�and Buffer Im rovement Plan � ❑ Escrow&Escrow reement • ❑ ❑ Other C7 O Other O D Other ❑ ❑ APRI.1Cf1NT ACKNOWLED(�EKAENT: . - __ _.... .__,. 1 Agrees to provide all information required or requested by the Planning&Building DepartmeMs; 1 Certifies t�at the information supplied is true and co�to the best of his/hsr knowledge. The applicant reoo9nizes ti�at they are solelyl responsible for submitting a complete application being aware that upon fsilure to do so, the staff has no alternative but to rejed it urrtil it is complete; • Som@ o�all of the information that you are asked to provide an this applica�on is dassified by State law as either private or cortfiidential, Private data is irrfcrmation which generally cannot be given to the public but can be given to the subjed vf the dsta. Corfidenb�al data is infortnation which generally cannot be given to either the public or the subject of the data. Our purpose and intended Yse of this�information i�to annually update our records and records of other govemmerrtal agencie�s required by law. lf you refu�se to supply the i�ormation,the permit may not be issued. Applicant's Sign . Date: — U v . l� l t�,_ Owner's Signature Date: � � I I ' . . I