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DEPARTMENT OF COAL MUh1ITY SERVICES
JNDIAN-PI Division of Building and Code Set-vices
Affidavit
RE: 11739 Gray Road
I, Joseph Steffen, do hereby inform and declare that the single-family residential home
located at 11739 Gray Road in Carmel, Indiana, will be residentially occupied by a
tenant and that the home will be furnished with water, electricity and heat as required by
local, state and federal laws.
Additionally, that this residential habitation be continuous and be a requirement in order
to secure a building permit to construct the proposed detached accessory structure
upon this property as provided by ordinance.
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(Signature of Notary)
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(Name Printed)
My commission expires on 20 1
ONE. CIVIC SQUARE CARWL, INDIANA 46032 317/571-2444
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(Name Printed)
Subscribed and sworn to before me this clay of - f , 20 Q ?6