HomeMy WebLinkAbout07040026 Correspondence
MAY-29-2007 TUE 12:23 PM
FAX NO,
p, 02
AFFIDAVIT
To be signed by Property Owner(.) alld Nswly Ass/gned Controctor
DATE: {; -j -07
BuildingPennitNurnber: CJ70'iOC~6
Permit Issue Date: f - /~ -0 'J
Notice is hereby given that1.tHlho./Y1 (;"rkA) brl1':f.j, LL '-
. PrevtOU$ ContrlctO.1 ame
above-referenced project and permit number, in whose name was issued for a
to be built at ;2:1 'If} -f, D w'br! dfl' ~uf+ :[111 S+~~f-,. _'
AddresroYCopstructto{ .
As of fa/ e/o 7 , responsibility for the completi,on of this project will be assumed by
Date iJ
D.B. Klc.!V Blo\i,. fl<; J I..Lc ' ,who hereby certifies by this Affidavit that any remaining building
New Contractor', Name. .
inspections will be performed and that the project will comply with, and conform to the Building Codes and Zoning
Ordinances ofCarmeVClay Township - 1980, adopted under the authority of Acts of 1979. Public Law 17'8 Sec. 1 et seq,
General As~ of the State of Indiana, and all Acts amendatory thereto.
W. - ~. . certifies that the construction will not be used or occupied until a Certificate of
New Coatr1l.etar
Occupancy (C/O) has been issued by the Depa.rtment of Community Services, Cannel, Indiana,
is no longer the responsible party for the
$~,Ie FG"'U~ .
p~ of Conwuctlcin
Property Owner(s) Signature:
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STATE OF INDIANA )
County of Mo.rion SS)
Before me, the undersigned, a Notary Public for ..Mo...r~UI/" County, State of Indiana, personally.~ppeared
~'d ' ' . , 1...'ll~~9USo1llll. '. . . 11ft"
I B. gIcun and acknow~~t~l~~n of the foregOllig1l1strument this day of
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SEE REVERSE FOR NEWLY ASSIGNED CONTRACTOR INFORMATION & SIGNATURE...
MAY-29-2007 TUE 12:24 PM
FAX NO,
p, 03
Contractor's Name (Assuming responsibiIity for project)
. .
6-j-cJ7
Date
~a()rd R. X/~/'AJ
(Print)
7/5"" CaS1-IO 7d-J, 5f.
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STATE OF INDIANA J
. . SS
Connty of Mo..tlOI\. )
Before me, the undersigned, a Notary Public for JA OJ Ion County, State of Indiana, personally
appeared JJOJ/ici ~. Kl c.J.n and acknowledged the execution of the fOregoinginsm\ment
this 11th day of :rlJn~ ,20 OL.
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otary Publtc, ,
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R.<v. Oet 2003
S:PennitB/Affidll..vit$INew Builder Affi4avit