HomeMy WebLinkAbout0794.86 AffidavitY
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APYTnAV=T
DEPARTMENT OF COMMUNITY DEVELOPMENT
40 EAST MAIN STREET
CARMEL, IN 46032
DATE:
TO:
FROM:
This is to certify that the (type of inspection) ;_�
for lot(s) of
subdivision and/or permit number
has been completed and done according to all applicable parts of the following:
One & Two Family Dwelling Code, The National Electric and/or the National Energy
and/or the Uniform Plumbing Codes; and for Uniform Mechanical Code; all as
amended. I certify that I am executing this document for myself or that I have
the authority of the entity I represent to sign it and that this document shall
bind that entity and all further reference to "I" herein shall be considered to
refer to such entity.
I further certify that I have executed this document in order that I may
complete this project without further delay. In further consideration of the
City's accepting this document in lieu of inspection, I agree to assume and
accept any and all liability for said project and will hold the City of Carmel,
its employees and agents, the Department of Community Development and the building
inspector harmless from any and all liability to any person or entity for the
failure to make such inspection and I further agree that I will pay the City for
any and all expense, including attorney's fees, resulting in any way from the
lack of said inspection or items not inspected.
DATE:
(S'gnature of Applicant)
(WitneXs)
State of Indiana )
County of H G \-,O )
IN TESTIMONY WHEREOF, I, have hereunto set my
hand and official seal, this Ib1r day of (�� 19�.
y a IVB for the
County of i 1 I tYN
My commission expires: fin! �i. 1Q92