HomeMy WebLinkAbout05030045-Master PermitC[T'Y OF. CARMEL
MASTER PERMTT APPLT. CATT. ON
The undersigned hereby opplies o the City of Cormel, Permit Services office
for on Zmpro~e'menT bocot!on?ermit (IBP) for Lot ~ in (Subdivision
Nome)
~ , , , The oddress of this Lot is
Avol/~nt hereby a~cees ro bu//d the same structure ~at ~s represented zh the
approved ~osreP Plan Fi/e on record with Permit Services. ~ny a/terat/~n ~o
rn/s opprove~ p/an w/// ~eqUl~e sub~ittl~ an ~vis/ons to
Or/=lnal Plan Zub~itted~ ~
Jno¢r Tn~ penalties of pedury (Zndian~ Code ~5-44-2-~), T hereby affirm under oath
ou of the information [ hove provided In thls Master Permit Application Is true and oc~urot¢
to Thc uesr of my knowledge ond bdlcf, ~nd that ~ hove not knowingly or JntentionoHy
prov~oca ~r omi~cd ony informotlo~ that would tend to hide obscure or otherwise misi¢~d the
Dc~T of ~ommum~ ~crvlccs regerdlng f~e truth of the m¢~¢rs addressed therein.
Nome ~A~pl~cant o~(Print) ~ture)