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2016-069Y
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2016-069Y
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Last modified
10/9/2016 1:21:01 AM
Creation date
7/25/2016 1:09:47 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Plan
Approved Date
05/17/2016
Control Number
2016-069Y
Agenda Item Number
8.B.
Entity Name
Emergency Services Emergency Services
Subject
Annex III Damage Assessment Guide
Document Relationships
2016-044
(Attachments)
Path:
\Resolutions\2010's\2016
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Attachment 5 <br /> OWNER <br /> RECONSTRUCTION/IMPROVEMENT AFFIDAVIT <br /> Folio #: <br /> Contractor Name: License #: <br /> Owner Name: <br /> Address: Phone #: <br /> I hereby attest to the fact that the repairs/reconstruction and/or remodeling list <br /> submitted for the Substantial Damage/Improvement Review by my contractor are ALL <br /> OF THE DAMAGES/IMPROVEMENTS sustained by this structure and will be done to <br /> the existing building and that all additions, improvements, or repairs on the subject <br /> building are included in this estimate construction herewith. No other contractor has <br /> made any repairs or reconstruction or additions or remodeling not included in the <br /> attached list. <br /> I understand that I am subject to enforcement action and/or fines if inspection of the <br /> property reveals that I have made repairs or improvements NOT INCLUDED ON THE <br /> ATTACHED LIST OF REPAIRS to MY HOME or that I have included non-conforming or <br /> illegal structures/additions, to the existing structure without having presented plans for <br /> such additions. I understand that any permit issued by Indian River County or <br /> appropriate Municipality pursuant to this affidavit does not authorize the reconstruction, <br /> repair or maintenance of any illegal additions, fences, sheds or non-conforming uses or <br /> structures on the subject property. <br /> STATE OF <br /> COUNTY OF <br /> Before me this day personally appeared who, being duly <br /> sworn deposes and says that he has read, understand, and agrees to comply with all <br /> the aforementioned conditions. <br /> Owner's Signature Co-Owner's Signature <br /> Sworn to and subscribed before me this day of , 20_ <br /> Notary Public <br /> My commission Expires: <br /> Indian River County Comprehensive Emergency Management Plan Annex III - Page 28 <br />
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