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Owners Release to Damage or Burn Structure <br />Having agreed with the building officia�, ���� �� v� <br />City <br />or County of S4ef`urh� , that a structure owned by <br />� <br />,j_� �i 1� ���(��-� [, ��� �SS and located at the following: <br />` Owner <br />County. ��`P�bv,�n-p <br />Township: � 1 k ii: <br />Fire Number: �`��� / <br />Nearest Cross Road: ���Cks� ��z <br />is under condemnation or unfit for human habitation and is beyond rehabilitation. I <br />further agree that the structure should be used by the fire service for training as they <br />see fit. I n order that demolition may be accomplished, I give my consent to the <br />City/Township of �l�t � �v�/ <br />structure� by burning or other means. <br />, •� , <br />,� �' � ��' f ��. j � � <br />- F�� G f f'C I1r L� Y <br />Owne� ,j` <br />f i <br />t <br />Owner <br />�'. <br />AgenU�uctors Representative <br />use or demolish the said <br />�,��� I �� <br />Date <br />Date <br />_11/��r'��a� <br />Date <br />4 <br />