Date:
_________________
(Name of Applicant) (Address)
hereby makes application to the City of Lyndon, Kentucky for a permit to:
(Explain nature of work to be done)
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_________________________________________________________________________________________________________________________
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(Location of work to be done or route of proposed move)
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(Date and time of proposed work or move and estimated time of completion)
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Applicant herewith submits in duplicate a sketch or drawing showing the location and proposed construction of the work covered by this application. If this application is for a permit to move overweight or over-dimension equipment or house, complete information as to size and type of equipment or house to be moved will be given above, along with route, date, time, and period of accomplishment of the move.
Applicant agrees that if this application is granted, the provisions printed on the reverse side will govern the work or moving, and that the same are a part of the application as if appearing in the body hereof.
Applicant further expressly agrees to save and hold harmless City of Lyndon, Kentucky and its City Council, as a body and individually and any of its agents and employees, from any and all liability of every kind whatsoever, which may result from work or moving performed under this application or permit.
________________
Company Name
By ________________
Approved ________________
Date ________________
Submit application and sketch in duplicate.
After approval:
Original will be returned to applicant
Copy will be retained by City Official
Upon completion of work or moving:
Applicant will return the original to City Official
(Ord. 150.17-1993, passed 10-11-93)