AGREEMENT TO REMOVE AN EXISTING RESIDENCE
PERMIT #: ____________________ PARCEL ID: ___________________________
ADDRESS: ____________________________________________________________
LEGAL DESCRIPTION:
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_______________________________________________________________________
_______________________________________________________________________
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As the property owner, I agree to remove the existing residence from the above described
parcel within 30 days of the Final Inspection.
I further understand that upon final inspection, a Temporary Certificate of Occupancy (TCO)
will be issued for a period of 30 days and that a full Certificate of Occupancy (CO) will be
issued once the residence has been removed.
______________________________________ ______________________
Owner Signature Date
______________________________________
Print Name
STATE OF )
)
COUNTY OF )
The foregoing instrument was acknowledged before me this _______ day of
__________, 2014, by __________________________________ who is personally known to
me or who has produced identification______________________________.
________________________________
Notary Public
(SEAL) State of ______________________at Large
My Commission Expires: