HomeMy WebLinkAbout22-5244Address: 4600 W Cypress St 200
TAMPA, FL 33607
Phone: (813) 574-5700
Fire Wall/Smoke Wall Inspection
Public Safety Impact Fee -Police
Driveway Fee
Mechanical Permit Fee
Sewer Connection Residential Fee
Building Plan Review Fee
Public Safety Impact Fee -Admin
SIF 1 percent Fee
Transportation Impact Fee - City
314 Water Meter Residential Connection Fee
School Impact Fee - Single Family
City of Zephyrhills I'll
5335 Eighth Street
Zephyrhills, FL 33542 BNR-005244-2022
Phone: (813) 780-0020 Fax: (813) 780-0021 Issue Date: 11/22/2022
INMIM.-
Permit Type: Building New (Residential)
Class of Work: Townhome
Building Valuation: $232,680.00
Electrical Valuation: $34,902.00
Mechanical Valuation: $16,287.60
Plumbing Valuation: $23,268.00
Total Valuation: $307,137.60
Total Fees: $13,714.84
Amount Paid: $13,714.84
Date Paid: 11/22/2022 9:34:48AM
38187 Fallstone Way
Contractor: LENNAR HOMES LLC
$15,00 Plumbing Valuation Fee
$0.00
$254.00 Address Fee
$30.00
$45.00 Electrical Permit Fee
$214.51
$121.44 Mechanical Plan Review Fee
WOO
$2,090.00 Water Connection Residential Fee
$1'010.00
$180.00 Building Permit Fee
$1,203.40
$2635 Plumbing Permit Fee
$156,34
$33.53 Park Impact Fee - Single Family/Townhome
$769.56
$34.80 Electrical Plan Review Fee
KOO
$732.71 Transportation Impact Fee
$3,445.20
$3,353.00
L01=4
49 .14,
V j4j1'j.�jj1@j,'1#1j#j 11 1 1
F0 01! -111 fl —r- 1410,11111 - I #If I f—'11
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entities such as water management, state agencies or federal agencies.
I zlilli
i Irrigr1rillor i I 1111111`7111 1 1 1 1 1
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed in
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE
PEfIT OFFICEC)
a
11 Id M 1-4
ERR 1=1 70'
,7071 TAT M1,
Permit No. o<
nntp PprmittPd t
CohbubDiv:
County Parcel
Address/Location
Classification/Type of Use �-A
TRANSPORTATION IMPACT FEE Rate: Sq. Ft Unit:
Exempt o Yes 0 No How Determined
Impact Fee Amount _L_3Zone No. TAZ:
SCHOOL IMPACT FEE
Account (056) Single -Family Detached House Amount
(057) Mobile Home
(058) Other Residential
(123) Collection Fee
Exempt =Yes = No How Determined_
PARKSAND RECREATION FEE
Land Account Land Credit Land Total
Recreation Account _ Recreation Credit Recreation Total
Zone -
Exempt =Yes = No How Determined
11 I 1 1
141 IWIVAgm
Land Account Land Credit Land Total
Facility Account _ Facility Credit _ Facility Total
Exempt El Yes No How Determined - Total Amount
RESOURCE FEE ERU
Total Amount
1l!!l1j11m1!mlj,ljj� 1=1
ACKNOWLEDGEMENT BELOW DOES NOT IMPLY ACCEPTANCE OF CONCURRENCE, BUT SIMPLY REECEIPT OF A COPY OF THIS
FORM, PLACING THE BUILDING OWNER ON NOTICE OF THIS ASSESSMENT AND THE CONDITIONS OF PAYMENT FOR SAME.
9W
RECEIPT NO - DATE BY
U A L R V E A S, S I S T
v Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
RM
Parcel Tax ID:
Services to be provided: Plans Review X
Inspections
Note: If the notice applies to either private plan review or private inspection services the Building
Official may require, at his or her discretion, the private provider be used for both services pursuant to
Section 553.791(2) Florida Statute.
5TEVE WITH
the fee
owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services
indicated above.
Private Provider Firm:
Private Provider:
Address:
747 SW 2ND AVE- 5,0.
i4,357,& 358, GAINESVInE, F� 32601
Fax: N/A
Email Address (Optional): deb@virtualreviewassist.com
Florida License, Registration or Certificate #: (LTC # BU1967/ PX2300/ BN4615)
I have elected to use one or more private providers to provide building code plans review and/or inspection
services on the building that is the subject of the enclosed permit application, as authorized by s. 553.791, Florida
Statutes. I understand that the local building official may not review the plans submitted or perform the required
building inspections to determine compliance with the applicable codes, except to the extent specified in said law.
Instead, plans review and/or required building inspections will be performed by licensed or certified personnel
identified in the application. The law requires minimum insurance requirements for such personnel, but I
understand that I may require more insurance to protect my interests. By executing this form, I acknowledge that I
have made inquiry regarding the competence of the licensed or certified personnel and the level of their insurance
and am satisfied that my interests are adequately protected. I agree to indemnify, defend, and hold harmless the
local government, the local building official, and their building code enforcement personnel from any and all
claims arising from my use of these licensed or certified personnel to perform building code inspection services
with respect to the building that is the subject of the enclosed permit application.
I understand the Building Official retains authority to review plans, make required inspections, and enforce the
applicable codes within his or her charge pursuant to the standards established by s. 553.791, Florida Statutes. If 1.
make any changes to the listed private providers or the services to be provided by those private providers, I shall,
within I business day after any change, update this notice to reflect such changes. The building plans review and/or
inspection services provided by the private provider is limited to building code compliance and does not include
review for fire code, land use, environmental or other codes.
The following attachments are provided as required:
1. Qualification statements and/or resumes of the private provider and all duly authorized representatives.
2, Proof of insurance for professional and comprehensive liability in the amount of $1 million per
occurrence relating to all services performed as a private provider, including tail coverage for a minimum
of 5 years subsequent to the performance of building code inspection services.
(signature)
Print
Name:
Address:
Telephone
No.:
Please use appropriate notary block.
MR7JUVOTM011
Individual
Before me, this day of
, 20personally
appeared
who executed the foregoing instrument,
and acknowledged before me that same
was executed for the purposes therein
expressed,
Corporation
LENNAR HOMES. LLC
Print Corporation Name
By:
(signature)
Print
Name: Christopher Smith
its: Authorized Agent.
Address: 700 NW I QZth Ave
Miami, FL 33172
Telephone
No. 813-574-5
Corporation ;� 22ND
Before me, this day of
MAY 2o_22,
personally appeared
of
Lennar Homes, LLC a
corporation, on
behalf of the state corporation, who
executed the foregoing instrument and
acknowledged before me that same was
executed for the purposes therein
expressed.
Partnership
Print Partnership Name
Im
(signature)
Print
Name:
Its:
Address:
Telephone
No.:
Partnership
Before me, this day
Of 20_,
personally appeared
partner/agent on behalf of
a partnership, who executed the
foregoing instrument and
acknowledged before me that same
was executed for the purposes therein
expressed.
Personally known X ;or Produced identi cation Type of identification produced
Signature of Notar �a2,
PrintName ASHLEE CALLAHAN
Notary Public Stamp:
ASHLE CALLAHA"N
E
Commission Expires: w Notary Public w State of Florida
-'44 GG 244456
NOVEMBER 30, 2022 mr.cornm expl(e5 Nov 50, 2022
DINOWYAP!
VR/\
VIRTUAL. REVIEW ASSIST
Private Provider
Plan Compliance Affidavit
Private Provider Firm: Virtual Review Assist, Inc.
Private Provider: Debra Anne Klahr, BU 1967
Address: 747 Southwest 2 d Avenue
Gainesville, FL 32601
Phone: 813-391-2959
Email: luc�,(&,�vhttia�ireviewassist,cotii
Project: New SFR
Address(s): 38187 Fallstone Way
I hereby certify that to the best of my knowledge and belief the plans submitted were reviewed for and
are in compliance with the Florida Building Code and all local amendments to the Florida Building
Code by the following afflant, who is duly authorized to perform plans review pursuant to Section
553.791, Florida Statute and holds the appropriate license or certificate:
Name: Debra Anne Klahr
Plan Sheets: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,Ll, SN,
SNI,S3,S4,S5,S6,SS,ST,D1,WP,PAI.0,PAI.1,PAI.2,PAI.3, SHI.0, SHI.l,SHI.2,SHI.3,SHIA,SHI.5
Florida License/Registration/Certification 4(s) and description:
FS468 Certified Standard Plans Examiner
License #: PX2300
Signature of Reviewer: lyn-
--7�
SWORN AND SUBSCRIBED before me by Debra Anne Klahr
being personally known to me or having produced as identification
and who being fully sworn and cautioned, state that the
foregoing is true and correct to the best of his/her knowledge or belief.
kvu-i—
ISignature of Notal'y Print Name
Notary Public: NOTARY STAMP BELOW My
A-SHLE
-E Cx
R
commission expires:
CO G.' 2
PIP'X'Os Nov
M
Ing imp] Immoluall Em
FIRE MARSHAL #01 -
Rea uired Permits
rl—TETFSMW• •�
WBuilding
El Ins ctiOnly
VI'lumbing
❑Inspection OnL
Elon
WMechanical
Ej ln�pection OnI
y
WElectrical ' Amp
E] Inyection Only
Roof
0 Gas
j
El Medical Gas
0 Fire Sprinklers
On Site Piping
E] Fire Line
❑ Irrigation
E] Fire Alarm
E] Potable Backflow Assembly
F-1 Fire Line Backilow Preventer
Irrigation Backfiow Assembly
0 Demolition
EJ Walk-in Cooler
[:] Refrigeration
El Hood
R Ansul,
El Fence/Wall
[I Grease Trap
E] Other
0 Other
MRIT11 M, I=
Type Construction:
—1
Risk Category:
Occupancy Load
Oan Classification:
FaC
ctory
WFac
C Residential
Assembly =� Fl3usiness Day Care/Educational
Hazardous E== Institutional ❑Mercantile
Storage E== t�E]Utility
1—Level 3
Building Use: Single Family / Alteration [E—:]Level 1 11:1 Level 2 1J
VNew Construction ❑ Interior Finish n Interior Remodel El Exterior Remodel E] Addition F-1 Revision
Overall Size:
18-4
Number of Stories:
2
Total Sq. Ft.:
1939
Living Area: 1541
Covered Area: 398
# of Bedrooms: 2
# of Baths: 2.5
Cost per square foot:
J!stim:ated Value:
Roof Type: tK Shingle
ElTile El Built-up E] Metal E] Other Squares: 13
Zoning:
Wiorne Debris:
r0l, &0] Inside C9111 Outside
Energy Code:
405-2020
Flood Zone: X
Base Flood Elevation:
Finish Floor Elevation:
Yes
Hydrostatic Vents? Yes 1No
Sq. Ft. Enclosed Space Below BFE:
# of Vents:
Size of Vents:
Total Sq. In. Permanent Openings
Central A/C
Gas A/C
g Heat Pump M Window A/C
0 Gas Heat 0 Electric Heat
Sanitary Sewer
Storm Sewer Catch Basins
Potable Water
Underground Fire Line
Front Rear Left Right
Asper Approved Site Plan
Comments:
f
813-780-0020
r• * '••
Building Department
Date Received
Phone Contact for Permittin
908 770 7763
--
1 1 1 1 1 1 1 1
1 1 1
1
Owner's Name
Lennar Homes, LLC
Owner Phone Number
813.574.5700
Owner's Address
4301 W Boy Scout Blvd, Ste. 600, Tampa, FL 33607
Owner Phone Number
s�
Fee Simple Titleholder Name
TN/A
Owner Phone Number
Fee Simple Titleholder Address
NSA
JOB ADDRESS
38167 FaIlStone Way
LOT # ®®71
SUBDIVISIONTownes
at Autumn Palm
PARCEL ID#
15-26-21-0030-06100-0010
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
P
NEW CONSTR F--] ADD/ALT
SIGN DEMOLISH
INSTALL REPAIR
PROPOSED USE 0�
SFR COMM
OTHER
TYPE OF CONSTRUCTION
tIY....�
BLOCK FRAME
STEEL
DESCRIPTION OF WORK
Multi -family / Screen Enclosure / Fence
BUILDING SIZE U/R IF 1939 SQ FOOTAGE 1541
HEIGHT 1 26'
�1®.
(.��BUILDING
. Ire. . . t"1"1r�
T VALUATION OF TOTAL CONSTRUCTION
$
232680
[$ 3 9902
(JELECTRICAL
—
V SPLUMBING $ 23268
MECHANICAL $ 16287.6
=GAS Z ROOFING
FINISHED FLOOR ELEVATIONS I==
PROGRESS ENERGY W.R.E.C.
AMP SERVICE
e.
VALUATION OF MECHANICAL INSTALLATION
SPECIALTY OTHER
FLOOD ZONE AREA DYES Do
BUILDER COMPANY Lennar Homes, LLC
SIGNATURE _ REGISTERED Y/ N FEE CURREN Y I N
Address 4301 Bo1� Scout lvd Suite 600 Tampa, FL 33607 License # I CGC1518166
ELECTRICIAN COMPANY Edmonson Electric, Inc.
SIGNATURE REGISTERED Y/ N FEE CURREN Y I N
Address License # I EC13005408
PLUMBER COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y / N FEE CURREN Y / N
Address License # LCFC042998
MECHANICAL COMPANY Bayonet Plumbing, Heating & AC, Inc
SIGNATURE REGISTERED Y/ N FEE CURREN Y I N
Address License # I CAC058062
OTHER COMPANY C Sterling Quality Roofing, Inc
SIGNATURE F REGISTERED L_I_LN__j FEE CURREN Y / N
Address License # I CCCO57991
I I I I I I I I I I I I I I I I I I I I I I I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
RESIDENTIAL Attach (2) Plot Plans, (2) sets of Building Plans, (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
*"'PROPERTY SURVEY required for all NEW construction.
.�®
Directions,
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over $7500)
— Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
Driveways -Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may besubject to^deed^restrictions"
which may bemore restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hived a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and |oon| regulations. If the
contractor is not licensed as required by !evv, both the owner and contractor may be cited fora misdemeanor violation
under state |evv, If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised tocontact the Pasco County Building Inspection Division —Licensing Section at727-847-
8OUQ Fudhennone, if the owner has hired a contractor or ountnsotoro, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, an the owner sign as the
contraotnr, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply tothe construction of new bui|dingo, change of
use in existing bui|dinga, or expansion of existing bui|dinga, as specified in Pasco County Ordinance numb*r@Q-O7 and
80'07. as amended The undersigned also underatenda, that such fema, as may be due, will be identified atthe time of
permitting It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate ofoccupancy" or final power release. If the project does not involve a certificate of occupancy or
final power re|*aae, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances,
CONSTRUCTION LIEN LAW (Chapter 713,Florida Statutes, ms amended): |fvaluation nfwork ia$2.5O0.00ormore, |
certify that |, the applicant, have been provided with o copy of the "Florida Construction Lien Law —Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the ''owner'. | certify that | have obtained a copy of the above described document and promise in good faith to
deliver ittothe ''mmner^prior tocommencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: | certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable |ewo regulating uonstruohon, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. | certify that no work or installation has
commenced prior to issuance of permit and that all work will be performed to meet standards of all laws regulating
uonatructinn. County and City codea, zoning nagu|ednne. and land development regulations in the jurisdiction. | also
certify that | understand that the regulations ofother government agencies may apply to the intended work, and that it is
myresponsibility toidentify what actions | must take tobeincompliance. Such agencies include but are not limited to:
- Department ofEnvironmental Protection -Cypress Beyheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
- Southwest Florida Water Management Diatriot-VVe||n, Cypress Bayheodn, VVeUand Aneaa, Altering
Watercourses.
- Army Corps of Engineers -Seawalls, Docks, Navigable Waterways.
- Department of Health & Rehabilitative Semicea/Environmental Health Unit-VVe||u, Wastewater Treatment,
Septic Tanks.
- USEnvironmental Protection Agency -Asbestos abatement.
Federal Aviation Authorib/-Runvveym
| understand that the following restrictions apply tothe use offill:
Use offill ianot allowed inFlood Zone ^\runless expressly permitted.
If the fill material is to be used in Flood Zone ''A^, it is understood that a drainage plan addressing e
"compensating volume" will be submitted at time of permitting which is prepared by o professional engineer
licensed by the State ofFlorida.
If the fill material is to be used in Flood Zone ''A" in connection with a permitted building using stem wall
construction, | certify that fill will be used only tofill the area within the stem wall.
If fill material is to be used in any area, 1 certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to edw*me|y affect adjacent propertieo, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, on engineered drainage plan is required
If | am the AGENT FOR THE OWNER, { promise in good faith to inform the owner ofthe permitting conditions set forth in
this affidavit prior to commencing construction, | understand that e separate permit may be required for electrical vvork,
p|umbing, signa, vveUe, poo|a, air conditioning, gam, or other installations not specifically included in the application. A
permit issued aheU be construed tobmo license to proceed with the work and not as authority toviolate, cancel, e|ter, or
set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes, Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit iaouonoe, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may he naqueabad, in vvriting, from the Building Official for o period not to exceed ninety (QO) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
Subscribed and sworn 6 (or affirmed) before me this
7/28/2022 -by Christopher Smith
Who i rson�j��o me or have PF9d61Ged
as identification.
Notary Public
Commission No. snzssos7
Stephanie Farmer
Subscribed and sworn m(or affirmed) umum me this
7/28/2022 by Christopher Smith
�A���� or has/have produced
as identification.
F �___ Notary Public
Commission No. ___GG 296057
DESCRIPTION: I.OTI51> -] B. TO"', AT AUTUMN PAINS,
ACCORD ( Q A REO: R C( J OOh ,
AGES O ! ;= PU C 2COISUS OL nASlO COUM" —RtDA.
NOTES:
LOTGiADAG SYFE=.
PROPOSED PAD ILEVATON - 5I83
rRONT SET EAG: -!S
Ifl- 1--10
REAR SYTMCI<- 20
ALL WALK 3 0 —T I' NOTED
ALLAfC —3.2
I, /U/D rt LNGRESS EGRESS/
PROPOSED:
LCWEST:LOOR U EVAPON$:
A ASIA.33
t EVA 1(TN$ REF _ ENCED TO
NORTi+AMERiCALS- VER-'CA. J-A=UM OF
9E8
�0 AitO 1- (trEOUE"11C VERTICAL.
UA iI.]M O
SF 1 15 TWP. 26 S, RNG 21 1
PASCC COUh'Y.f ORID.A
( =OWNES A; AoTUM\, =ALMS)
CURVE DATA (P)
CURVE RADIiIS ARC IENG'rH G40125tENGTIi CHOIiU 6EAR;NG DELTA ANGLE
C� 19.00 29.6] 26.89 S44`544 ]'E 9Q'OS'IB
7
o m2t
I3 f-NIIS
o
> 3
go
j
ENTI
y i
t STORY
ETSIDERNCENCE
RES
ENTRY
20 0
la
)�
zo.o
fr
zo.o" .
_
III1 NTFY
LOT
79
NIT -A
532
1OT
78
L-
uN;T e
51e
LOT
77
IN;T.I
24
LOT
19 b
]N IT C
624
LOT
75
o. oo'IP1
UWT<
1624
LOT
74
IT c
LOT
73
UNITS
516
LOT
72
1532
LOT
SITE PLAN
NOTA SURVEY/
a,l
�
ZAP
1 RAC- D
AVArED1UrNAGEE EMENT
R0
0
,Do
T-
el",
\
N A9'S834' f P 83.V]' P
i SCONC WALK
ROADWAY TRACT
SD' WIDE R/W
CITY OF FEPHYRHI WS
VF/U7D EASEMENT
LOT
- 11103 SO. FT.
LIVING AREA
5336 SO. FT.
ENTRY
=,__E72 _.... SQ. IT
GARAGE
848 SQ FT
COVERED LANA;
868 SO
PATIO
NA SQ. FT.
POOL AREA
= _ NA _ SO. F?.
CONC DRI,o
_ 2100 SQ..I
A/C6 CONC EAU
80 _DSO.
SIDEWALK
324 S(,.
SD' YARr)SREALI
NA SQ. IT
CONSERVATQN AREA
= NA So I
Lot OCCUP?FD
6
AREA TO IRRIGATE
a 38 A
1708 Water Oak Drive
Tarpon Springs, Florida
Phone (727)-831-1990
Flo rldaPLS7123@gma,Lcom =1
LB# 8183
1,
e 4
Initial Point Land Surveying, LLC
Scale: 1" = 20'
0 20 40 60
ving LLC at Use time of thu site pla
2) a P P U rthooi 'N berxfi: of a n
h NA
D,E
d f q ow P. ent q o
3 1 R k All eon
M1crco kfrom n
eng.=,< <inq ola sunec
a.mirn:.re ow,�hlp.
j All meplan Is sr,gen to mxt�rs mown on m�vrat or rowNs cm
Aur MNvn:nI
6.)Dlmm.... shown M1e2on ate in feet nnG d- -- portly-z tnc -
}71 R 9 I
P
g C f }
nfo �.chovl, hereon. � r;sk.
j SURVEYOR,ktIERTlFICATE'
",
- It,rpry�(f P(oP Y
a y.P at FI, Pt5Y4,E )b.-artl tl f 'ce br
s
�hret <2ferre=��s t°�` yJeff Hartley
Date,: 122.07.28
Ha � �ORID�F6y�Ap' -04 00
NO'VALID w1T1 JJ{{(OtQOr
A" I
IT
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