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In connection with application for this: <br />( ) building permit <br />( ) septic tank permit <br />( ) subdivision exemption <br />( ) Mobile Home application <br />( ) other permit <br />Applicant acknowledges having read and understood the following: <br />1. Bent County in granting the permit makes no representation as to the status <br />of Applicant's title to the real property described in the application. <br />2. The County further makes no representation as to any matter which could be <br />disclosed in a survey, and if Applicant has any questions regarding location of <br />boundary lines, possible encroachments, either by the Applicant or by third <br />party, the location of any easements or rights of way, or any other matter <br />which would be property shown by a survey, the Applicant may obtain a <br />survey from a professional land surveyor. <br />3. The County makes no representation regarding Applicant's right to legally <br />access the real property described in the application. If Applicant has <br />questions regarding access, Applicant may engage the services of any <br />attorney or professional land surveyor. <br />4. The County makes no representation as to the availability of any utility <br />services to property, including but not limited to gas, electricity, water, trash <br />disposal or sewer. If Applicant has questions regarding the availability of <br />utilities, Applicant may request such information from the appropriate utility <br />provider. <br />Signed t is ) day of <br />BENT COUNTY PERMIT DISCLAIMER <br />A <br />, 2013 <br />