HomeMy WebLinkAbout0243.98 Miscellaneous AF$IDAVIT TO;INDUCE INTERIMiREMODGLING RELGASC
AND/OR.EARLY F.OUIYDATION'RELEASE
GITY OF CARMEL/CLAY'TOWNSI3IP `
p� � 's '� :
Date; 3 —�� �"0 ° � `
Building Peiniit'No.: �.�3, q g
Entity(Business or ^,�
Tndividunl):. ��CULL.DUCG� LU�'jqRUG),/Dl� CD:�l�(i.
r
APPlic�nf-Affiant:, D�,��i ��C VG1.0'U�a{.�
ProjectN�nte: �RQ►c�SD� �Og�QL�
- Address![;ocation: �'�$D �� XI�Q1Dl'p� ST, - �,f b
I;,being`d'uly slvom upon my oath, slate the follo�viiig: '
I'. I am'executing ttiis Affidavihfor:myself or assAie:authorized agentof the��bove-referenced Entity
to induce the City of CarmeUClay Township ("DOCS"),to allow me-oi the Entity lo proceed wilfi development
pursuant to lhe Plans(dcfined bclo�v).
2; That'this AffidaviC;shall'bindme or said Ei9[ity`and any furtlienreference fo'"I" herein sfiall be
considered;as;a refcrence`to me or�suclr Entily.
3. I liaye:filcd�vith thc Office of tlieSlate Building Co�nmissioncr("SBC"}oLllic;Indiv�n,Dcpmimcnl
of Fire and Building Services forits re�iew.and approval;plans and specifications(the"Plans")foc development
of the above-referenced project (fl�e "ProjecV'), wluch I belicve to,bc in,compliance;with all State oLlndiana
•regti�ements including, byl not,limited lo,the'tules,of the Fire Prevention,and Building Safety'Gommission,�lhe
Uniform Building C.odc, the Nation�l Electric Code,, lhe Nalional;P.lumbing Code?and the^Model Epergy';Coilc;
all asamended Gom [ime;lo lime;(tha"Rules").,
4; I fieve.presentedto.DOCS a^copy,of.the State Interim and/or Foundation',Release; ariy changes
submitted to.or required 6y tticSBC:�yill be subinitted to pOCS in a timely fustiion. Plan§,stamped with a final
approval and accompanied'.by a FuII;Design Release;will6e submitted'to'DOCS prior to scheduling the final'.
insPecGon and issuancebf a Certificate of Occupancy(C/0).
5. I.Curtlier uudc�sta�id"LhaLapplication forfln interim remodcling relcase �nd/or ca�ly foundalion
release u-ill only allow.me or the'Entit�?, afterpayment of tlie full-fce_:Co DOCS,to proceed at my/itsown:risk.
6. 1 uriderstand that by procecding on an interim basis, I accept responsibility fo� iemoving and
replacing Anyconstruction found;by plan examinationpr by.site inspecfion not to comply wilh,the Rule"s und/or
those rules and regulations of DOCS and/or ordin�nces of the Gity of,CurmeUClay Townsfiip:
Z. I furtl�eracknowledge that�I"am p�oceeding on an,interimb5sis at my/the Enlity's o��m,risk a��d IJi�C
I;assume'and.accept all liability for thc:project and�vill indemnify,and holil:qie City of CarmeUCl�y To�mship;..
its,officers; employacs and agents; hannles"s.Gom any uni] all 7ia6ility to any person or entity (including;lhe
Entity), resulting&om.procceding-fornard williout a stflmped set oC Plans and,n'Full Design Relense Gom=lhe
SBC.
8. I`further agree thaf:I will,pay Ihe:Oity-of Carmel/Clay Township,for,any.aqd alLexpenses;including
reasonable attorneys fees;it migfit incur irctaking enforcement action:against t6e Eroject:
� 9, I furlficr�acicnowlcdge lliat, in.�ddition to ihc Rules, I must comply �citli all ollier rules and
regulatiops o£the Cily.of,Garmcl/ClayTowriship and the St�te of Indiana ns sucli relate'lo ihe ProjecE inclu8ing;
-
but not.limited Eo,building,codcs and-zoning ordinaoces as amended Gom.tiinc totime.
DATED: J-I�' /�
,,�Q�° M°C��!e��i
Signature �
�AV 2D 1,,��:Cu�.t-o uC��J
Erinted,Name_
STATE OF,INDIANA `)
)SSi
COIJNTY OP HAMILTON )
Personally appeared befor8 me,, a Notary Public, in.and for� �J C� County; State of Indian�,
' ncknowledged lhe execution of the'fo�egoingAfiidavit and;indicated:that�thc facts,staleil tliercimare cn�e. Tlie
Affiaut further representad il�at he/she has propc�authority and resolutions to executethis,A�davit-on,behalf
of die entity. �
Witness my,liand and Notaridl`Seal`t]us /� . day of ���7��"l l9 �d
�"//1,��� ���%a��''c�
Notary�Publio-
�Ga6/i/C Q' /7_,Y/C /G'�C/
P"rinted
/
" 14fy'commissibn expiies: �0� / � 6ZC,, .S
. ,
s:fomis/�ffid�vit .
dg/y/gl�s�,
November 1997