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Dawson County Community Development 25 JusƟce Way Dawsonville, GA 30534 [PHONE REDACTED] PLUMBING SUB-CONTRACTOR AFFIDAVIT Site Address: This is to cerƟfy that I am responsible for the Plumbing installaƟon and compliance with all applicable codes. I assume all responsibility and liability for the installaƟon of the building sewer and water lines. I understand that it is my responsibility to ensure that the sewer and water lines are installed in compliance with the Georgia Minimum Plumbing Code and any local ordinances. Ordinances may be reviewed at dawsoncountyga.gov. I also understand that Dawson County requires a cleanout at the sewer tap. I relieve Dawson County and its Inspectors from any liability for damage loss of property or improper installaƟon. When installing an irrigaƟon system if it is being connected to an exisƟng water supply line backflow protecƟon and rain sensor will be verified at the Ɵme of the final plumbing inspecƟon. Do you hold a restricted license? Yes No If yes, is the scope of this work within the license restricƟon? Yes No Company Name State License Number ExpiraƟon Date Print Licensed Plumbing Contractor Name Date Licensed Plumbing Contractor Signature Notary Signature Notary Stamp