Waiver of Liability Form

Applicants Full Name:
Property Address:
City:
State:
Zip:
Phone Number:

I, , hereby acknowledge and agree to the following terms and conditions of this Waiver of Liability.

  • 1. I have read and understood Ordinance No. 2025-024.
  • 2. I understand that the technical design and execution of construction of pond is my responsibility.
  • 3. I will regularly schedule and accept inspections throughout project until a mark of completion is administered.
  • 4. I understand Delaware County and their offices are not to be held responsible for financial or property damage incurred during the pond development.
Applicant Signature
Date