Free Hold Harmless Agreement Template 21
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Regulatory and Economic Resources
Building
26th Street
Miami,11805
FloridaSW
33175-2474
Miami, Florida
33175-2474
(786)
315-2100
786-315-2000
miamidade.gov
miamidade.gov/development

HOLD HARMLESS

Date: _______/_______/______

Re: Property located at (address and legal description) ___________________________________________________________________________
__________________________________________________________________________________________________________________________
Gentlemen:
As legal owner of subject property, I request the cancellation of permit number (in full) ______________________________, issued to (name of
previous permit holder) ____________________________________________ (mailing address) __________________________________________
on (date) _____/_____/_____ for the following reason ____________________________________________________________________________
_________________________________________________________________________________________________________