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HomeMy WebLinkAbout03070225 Contractor AffidavitAFFIDAVIT To be signed by Property Owner(s) and Newly Assigned Contractor DATE: Building Permit Number: ~ Permit Issue Date:~ Notice is hereby given that __ is no longer the responsible party for the Previofls Contractor's Name above-referenced project and pennit number, in whose name was issued for a to be built at ; cfi ~.-~. /' i x/~dof Construction AS of ._,~_ff.~--~ % , responsibility for the completton of this project will be assumed by , who hereby certifies by this Affidavit that any remaining building 11 comply with, and conform to the Building Codes and Zoning Ordinances of carmevClay Township - 1980, adopted under the authority of Acts of 1979. Public Law 178 Sec. 1 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. certifies that the construction will not be used or occupied until a Certificate of O cc~pancy (C/O) has been issued by the Department of Community Services, Carmel, Indiana. (Print) Da~c Strccl Address ~ ~2~ Phone (Print) Date C .ty ST Zip Phone Phone STATE OF INDIANA ) · SS f County o ) Before me. 2ounty, State of Indiana, personally, a~ared and acknowledged the execution ofthe foregoing instrument this ~'Say of SIGNATURE... f of Mr. ~ of permits ~'~ TOTRL. PRGE,03 ~ respof~bility for project) ST Zip Phone STATE OF INDIANA ) ~/ ,~. SS County of,~ B~for¢ m¢~th~ Undcrsigngd, a _Notary P.u.bl.i~. fo County, State of Indiana, p~rsonally ~pp~d b - ~ ~, ~ a~ow~d~.~ ~x~outio~ o~ ~o~goi~g ~m~ ~-----~om~ission Exptre~: Rev, Oct. 2003 S:Permfts/Affidavits/New Builder Affidavit