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Home My WebLink About123470 970 S190873 Orr& Community GLENT/p.E Development Group NEW SWIMMING POOL PLAN SUBMITTAL AFFIDAVIT Ordinance#2046 Please type or print Date t_ .r 0 �� ; Property Address_6-6/ 1 Ge 6 r L _. Name of Property Owner. a /gre2 G I. 0 No children less than six years of age reside at this address. II. [l/' 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. [KW will provide an interior fence and enclosure around the pool as required by the Glendale Pool Barrier Ordinance. B. liWe 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 . i. IP' YOU CH1;;C1 i l) BOX II.l3, PLEASE CO11 1LI+,X E REVERSE SIDE WHICH is THE NEXT PACE IN THIS DOCUMENT THIS IS THE REVERSE irERSE SIDE.OP'Tag PREVIOUS PAGE l., 0 The pool shall be protected by a motorized safety pool cover, 2. 2(Doors and windows:tro protected 3. 5 l 1'ho pool shall be protected by an alarm maintained ill or on the wimming.pool, • 4, Cl The above ground swimming pool shall have a secured ladder, S. Cl Locking hard safety cover on the spa or hot tub, 6, © Alternative proteotlon not specified above which is attached to the • plan submittal and submitted for approval by the Building Official /612 ‘,4t6).2a-geeo #fitak,/ d61,7,!L-0 ;2-0,-20 Name of Flame Owner foot Ow • nature Cate • . . .3,. _OD Pool Contractor Contractor Signature Date State of Arizona County of hitaricopa • • On tbis_�,. _day of_ 20_, before me, personally appeared • _ _� _y ,• (name of signer), whose identity was proven to Inc on the basis of satisfactory evidence to be the person whose name is subscribed to in this document, and who acknowledged that he/she signed the above/attached document. /2 I; 70 • INDIVIDUAL ACKNOWLEDGMENT ®c a 0434ag ii ',;, P,si . State/Commonwealth of f'VY\ 001CL ss. County of CA-tr1 C_C.) 9C__ On this the c-)` C\ day of NJctnu.cur i aOD V , before me, �LDay Month Year C t r V- �• LwD lc\ �v , the undersigned Notary Public, Name of N tary Puil' personally appeared el-J'J 2X1 evi„_\ , Q. I---17 Name(s)of Signer(s) 0 personally known to me-OR- )proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within Instrument, and acknowledged to me that he/she/they executed the same for the purposes therein stated. WITNESS my hand and official seal. (tosto HEATHER D YOUNGKER �I.Cu�� a� C. Notary Public Arizona Signature of No Pubic iP Maricopa County kia My Comm. Expires Feb 4,2020 Any Other Requi d Information Place Notary Seal/Stamp Above (Printed Name of Notary, Expiration Date, etc.) OPTIONAL This section Is required for notarizations performed in Arizona but is optional in other states. Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document:I 31)-)1 MrIUr\J C� -pop e p\an c- 7d ti 1`c Document Date: \ I ? l l ZO ZU 2 Number of Pages: Signer(s)Other Than Named Above: ©2018 National Notary Association I i M1304-07 (09/19)