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PPS. Community
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GLEN1p Development Group
NEW SWIMMING POOL PLAN SUBMITTAL AFFIDAVIT
Ordinance #2046
Please type or print
Date y\ 15 1 11 -- —
Property Address (C 22 ,.) -F)6-t -„t oo c\ (r C,kin cL\e A 2 RS3 0-S--
Name of Property Owner a�r'L- S„441-
I. El No children less than six years of age reside at this address.
II. A child under the age of six years of age resides at this address.
(If this box is checked, identify method of secondary pool protection)
A. El We will provide an interior fence and enclosure around the pool as
required by the Glendale Pool Barrier Ordinance.
B. We will provide exterior fence and enclosure protection with
secondary protection as checked on reverse side of this affidavit per the
Glendale Pool Barrier Ordinance.
13
WELLS
FARGO
Jurat Certificate
State of 1'1 1 N V
County of U 1 co yirl
Subscribed and sworn to(or affirmed) before me on this \ f\
day of 20\1 by nT�n�� 1 V I,
Place Seal Here Notary Signature 'cy �� U
belay Dorado
Notary Public
*tope County,Adzor*
*.Z. My Comm.Expires 09-17.12022
Commission Na 553519
Description of Attached Document
•Type or Title of Document
I_t\N S VN 1 'M I N Cr ?\ C\N _Cs1/1 r1C1l_W12 1_ R FT-a V IT
Document Date Number of Pages
11 1 \ - l l (71 / \N C1\91ry - l' S poi rl e
Signer(s)Other Than Named
��IAbove
D5G3018(Rev 00-2-15)