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. <br /> , PERMIT APPLICATION �, <br /> i <br /> i <br /> UTILITIES LOCATE CONFIRMATIOIV NUMBER:. <br /> PROVIDE SKETCH IN THIS AREA, IF ADDITIONAL SPACE IS REQUIRED,ATTACH TO THIS <br /> APPLICAYION. <br /> See attached Plan <br /> AFFIDAVIT: Applicatfon is hereby made to obtain a permit to do work and installations as indicated. I certify that all fore�oing <br /> informadon is accurate and that all work will comply with all applicable codes. I understand these codes shall take precedence over all <br /> approved construction documents,and issuance of this permit is verificatiori that I will notify the property owrier.of Florida Lien Law <br /> req.,F.S.713: <br /> The issuance of this permit does not ensure compiiance with deed restrictions and I understand that additional deed <br /> restriction's may apply to this property. <br /> Ali work shail comply with the curreret Florida Building Code, Public Works Design Manual and FDOT Design <br /> Standards(if applicable). {Public Works Design Manua)online link:www.a.zephyrhiils:fl.us/public works.asp) <br /> APPLICATION IS VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND WITNESSED BY A PERMIT <br /> TECHNICIAN OR NOTARY PUBLIC. <br /> NOTE: The City of Zephyrhills is not responsible for maintenance or repairs of driveways. Driveways shall not alter/ <br /> interfere with existing stormwater treatment and/or oonveyance. <br /> PROPER7Y OWNERS: By signing this application: I cer' t ve read and understand the owner/builder disclosure <br /> statement. (please initial) <br /> Craig L. Come i�son �� /� <br /> Old 5th Investments. LLC <br /> Applicant Print Name Appl' ignature Date <br /> Permit Technician Signature (or)Notary Signature Date <br /> Applicant is( )personally known to me or p�oduced as idehtification. <br /> (type of identification) <br /> Page 2 of 3 <br />