HomeMy WebLinkAbout0170.97 Contractor Affidavit ����o �r�� � �
I;CERTIFY THAT ALL OF THE ABO�TEDsINFORMATION'IS SHOWN'COMP�ETELY AND ACCURATELY ON THE
ATTACHED ?LOT OR SITE'BLAN AS.�JBMITTED,_VVITH A BUILDING PERMIT APRUCATION TQ THE CARMEL-CLAY
DEPARTMENT OF COMMUNITY�SERVIGES I FURTHER CERTIFY�THAT THE JOININGOF INATER SUPPLY PIPING
SHA�L BE MADE WITH LEAD-FREE SOLDERS AND FLUXES: FAILURE'TO GOMPLY WILL RESULT IN A
_, �,_ ,
REPLAGEMENT OF THE SYSTEM.,PLUMBING'CODE.R 509`-S:
BUILDER'S SIGNATURF�i����/'Ql/yi,�tit e PHONE:��,�- SCo�s
ADDRESS: �5��/c Gf��'/Pf/�'/-' I�u N . �.vD.�<,C. �fJ ��.23 �
NOTE: Additional plans andlor informationlmay,be requited,'if submitted plans are:not of sufficient clarity or detail, to
indicate tfie natute;and e�ent of the work proposed and to determine compliance with all applicable codes and
ordinances.
In addition to the above, the Building lnspector will be provided,with any information relative to commitments made
in the zoning process for tfie propeity involved. This would include any ADLS and BZA activity.
April, 1996 s:form�mprvloclperminfo