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Q � _IMAVEAN�YNLIIMMAMACERTIFICATEOfCONSENTTOSElF�NSUREFOAYIORKERS' _ � . - , � . _.� � COMOENSATIDN,ASVRO�ADEDBv4ECTON77DOOFiMEtAHC%iCOOE,FORiHEVERFORMMILE W OFT1E VIOiYC FOR WH1CN THIS VERIAR IS ISSUED. � � .�IHAVLANDWRLAUNTAMMiORI(ERSOO�APENSATIONINSUNANCE,/SREWiRCDBYSECiqN �7 1� QQ J7000FTHElIBOROOOE.FOR7HEPERFORMANCE FTHEWOFNFORWHICN7HISDE �TIS // � ISSUED.W WORKEF5COAIPENSATIOY1HiN1�. .R � .�+�� STF�UCTION • v _ O �QL cr�-- PLAN REVIEW � CARPoER �iyf 0 POLICYNUYB[R ELECTRIC T� �?' � ���� � g �+ O � .K L J.J.a! 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CONSTRUCTION LEND�NG AGENCV PRE•ALT FE�E:�� � INEREBYAFFIRMUNOERiENALTYOFPERNRVTHATiHEREISACONSTMICTIONLENDWOACENCY ' / �Y _ _ �Z- FORiHEVERFORMNICEOFTHEWORKFORWHICi1TMISPERMiTI5155UED(SEC.9oV7,pY.C.4 �C=L� ' . W � LENDER'S NAME � � LENOER'ShDORE55 /'� W ICERTIFYiNATIFUVEREA0TH1411VPLICATIONNIOSTATEiM�TT1EABOVENFORMATqNISCORRER TOTAL FEES / �"/ gZ � � � p_ IAGNEETOCOMPLYWITHALLCfTYANDCOUNTYOH0INANCE5u105TATEUw`+PELATwOTOBInLDiNG !/�F' �'"� COPLS7RUCilON.IUS�HEREBV AUTHORIZE RE�PESEMATNES OF TNIS COUNT7T0 EHTER UPON THE S� AflOVEJAEMIONEDVROPEHTVFORINSPECiIONPURPOSEi COMMENTS - � 0 J � aPE I . E(P u� b I � . , n . n nC/ . / . � 51G U PE fEE OA7 � RECPT.NO, PAID 6Y VALIDATON— _ ___ WHITE—Depenment Capy.YELLOW—Finence Copy.PINK—Aexesa Copy.GOLDENRO�File Copy.GREEN—AppicanYs Copy � �..r�.�Y.....�.. t;._..�n��. . �1 . �. � ..� . • •� � �'M ' �4 . .r ti . .p.,,u.,. .,,..�.,,..::- . . ���......- •�.:y� � . .v_. ,} � :..�., t , . 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