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HomeMy WebLinkAbout614 SHASTA LN - Building Permits D j City of Costa Mesa Planning Department Post Office Box 1200 • e 77 Fair Drive m5' o „r, Costa Mesa, California 92626 p c (714) 556-5245 REQUEST FOR OCCUPANCY (Single Family Residential or Condominium Units) • Tract No. L;?"' 4' ` Date y5-.---`" C' Tr"- / 7 Lot No. ! 69? Address b t' U �� The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he, )renrey) .--c14—.P. (was of—were)l� ised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the City at the time the final tract map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. RECEIVEDB • �' . • CITY OF COSTA MESA y Purchaser • AUG 19 1977 �a�'�►/i. AM PM By • '�� a a rai 718191101111]2111213141516 D r er an nr .1 �/�� '-"ice By dm. N. • „ 17731 IrvinerBlvd. • Tustin, California 92680 CMF 0569-26