HomeMy WebLinkAbout07050083 Builder AffidavitAUG-15-2007 WED 12:15 PM CITY OF CARMEL BCS FAX NO. 3175712499 P. 03
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pia AFFIDAVIT
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!HDIA
DATE: fj• 9 ?- A m o 7
Building Permit #
07 0500 83
Issued: 05 /f .200
p? T be signed by Contractor
Notice is hereby given tLa / a is no longer the
(Contractor's Name) r n?
responsible patty for the Pblove reePenced p o ect in whose name buildinngg pe?rmiit lF?O JU t s
issued for a i le- Rum /V Pt) Mfto be built at / y Z/0
(1 of Construction) (Address)
As of fl _ / LP - d -7, responsibility for the completion of this project is being assumed by
(Dare)
others.
........ .........................
Contractor's Name
GLen?C ,PLI
•..... a ./............• e.......... a a..../.J•
..
14 (Doing Business AS)
-T, ;? /- (9
cPncia (Date)
Gonuactor's Address and Telephone Number:
317. ??? ?xW?16?X7
SPATE OF INDIANA )
SS
Counry of am fctl)
Before me, the undersigned, a Notary Public for County, State of Indiana,
personally appeared ?l j Jan n N , ?` and acknowledged
the execution of the fon:going instrument this o"?u_ ??11_ day of 20le?_-.
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