Upon approval of this request for this modification/request, I/We will assume all liability for any damages incurred as a result of this request as well as any additional maintenance costs that may be incurred. I also agree to obtain any permits that may be required by any government agencies for this modification or request.
If necessary, I will forward the following information to Corey Holton:
(1) All plans, drawings, pictures, etc., along with color samples if appropriate. (2) A site survey showing the location of the improvement or request.
Forward all materials to: Signature Realty & Management, Inc. Attn: Brent Heinselman 8215 103rd Street Jacksonville, FL 32210 (904) 904-482-1099 Phone (904) 904-322-5294 Fax
