HomeMy WebLinkAbout0002.91 Contractor AffidavitAFFIDAVIT
DEPARTMENT OF COMMUNITY DEVELOPMENT
1 Civic Square
Carmel, IN 46032
DATE: ✓ _ 6 —C/I
FROM: C /%%r�i �/✓
This Is to cenly that the / 001111.6 for lot )' of
(Inspection)
rolr E�7' subdivision, permit number Z- y/ 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 Code and/or The Uniform Plumbing Codes and the Uniform Mechanical Code, all as amended. 1 certify
that I am executing this document for myself. or that I have the authority from the entity 1 represent to sign it, and that this
document shall bind that entity and all tunher reference to 614 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 Wrther consideration of. the City's acceptance of 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 an all expense, includ', g attorney's fees, resulting in
any way from the lack of said inspection or items not inspecte
DATE: 6 �I
STATE OF INDIANA )
County ot�) j
B e me, t~e undersigned, a Notary Public for I ` Q 10%\ County, Staie of Indiana, personalty appeared
(C //, ) and acknowledged the execution of the foregoing instrument this (_ day of.
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My Comm�issiio�n� Expires:
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