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HomeMy WebLinkAbout05090188-Signed DemoTO BE Enforcemenl NOTE: Demo uirements City of Carmel / Clay Township Building & Code Enforcement; City of Carmel IN 46032 Ph. (317) 571-2444 Fax (317) 571-2499 ed by the appropriate and fuel )vernment entities, or ~ility of the Jch approvals. Well must be plugged according to Well Ordinance A-62. must be pumped and removed from building and/or property. Tax Map Parcel # nclude that information,) of THIS PAGE) when you submit your application package. ations, City of Carmel; FAX (3f7) 776.8506. S:Permits\Dernolition permit handout I of 2 09/2612085 13:19 F~o~; 3175712265 C~RMEL LITILITIES P~GE 82/82 0~122/2005 0~:~6 #252 ?.OO~ CERTIFICATE OF AUTHORITY Under the penalties of perjury (Indiana Code 35.44-2,1), I hereby affirm, under oath, that all of the Information I have provided in this application for demolition permit Is trna and accurate, to the best of my knowledg~ and belief, and that I have not knowingly or Intentionally provided or omitted any InformaflDn that would tend ~o hide, obscure, or otherwise mislead the Department of Community Servlc,~s regarding the truth of the matters addressed therein. Further, I assert that ! am the property owner, or the authol'lzad and lawfully appointed agent of the owner(s), that I have e.?mss authority and permission from the owner(s) (and anyone with a recorded interest or ether interest in the property), I; take this requm,"ted action, and that I agree to Indemnify and hol;~ harmless the City of Carmel from any claim, lawsuE, demand, or damages whatsoever arising m~t of, or as a result of. this request or the actions of the Ci[y of Carmel, regarding same. (Name p~nflad~ Appli~ant'a Address _,-%, Date City, ST Zip 'STATE OF INDIANA ) County Before me. the uadarslg;ted, a Notary Pub[Ic f~r ' Coun appeared, and aekn~wle~ ~e exe~on ~ the ~mgoln9