HomeMy WebLinkAbout123522 Pexpk- P35 ,2.
Community
GLENLIE Development Group
NE.W SWIMMING POOL PLAN SUBMITTAL AFFIDAVIT
Ordinance 02046
Bleak ne or print
Date 1211 t. (1")
Property Address 81f.1 'J . Fnt.i
Name of Property Owner -30\rti Nvv-k r
t, XE\ No children less than six years of age reside at this address.
II. Cl A child under the ege of six years of age resides at this address.
Of this box is checked, identify method of secondary pool protection)
A, l~7 We will provide an interior fence and au4uaure around the pool as
required by the Glendale Pool Barrier Ordinance.
B. 0 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.
s=
.... .. ... . . .
IF YOU CHECKED BOX II B, PLEASE COMPLETE REVERSE SIDE
WHICH IS THE NEXT PAGE I THIS DOCUMENT
TIIIS IS THE REVERSE SIDE or THE PREVIOUS PAGE
1. 0 The pool shall be protected by a motorized safety pool cover.
2. El Doors and windows are protected
3 The pool shall be protected by an alarm =untamed in or on the
swimming pool,
4, 0 'rho above ground swimming pool shall have a secured ladder.
5 0 Locking hard safety cover on the spa or hot tub.
6. 0 Alternative protection not specified above which is attached to the
plan submittal and submitted for approval by the Building Official
—1-1114-1641esslur
iZ/MAP43
Name of flame Owner FkimeO i Date
_
// 701/ //1/1—e 247
Pool Contractor Contractor Signature Date
SICNATURE OF OWNER MUST lit: NOTARIZED
State of Arizona
County of Maricopa
On this day ofe6P-illie420 j 7 0 before me,personally appeared
01 arcYwic.42,2,.... (name of signer), whose identity wa3
proven to me on the bash of satisfactory evidence to be the person whose rune is
subscribed to in this document,and who azknowledged that he/she signed the
aboveiattached document.
NrillbadardhoismayaNiftahawaysi.db., :4
40"1"14 BARBARA JEAN DURBIN
ta Notav Pubic-iozona
Maxon County
• • My Comm Expires Dec 28.2021
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