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<br /> -.. . � "f`r 'S � • . � ,
<br /> T�CE OF DEED.RE37RICTIONS:�The,undersignect��untlerstand���#.h�t;ttaiat: it:�.may;be;sub e.ct�.to:°aeed";reskic.tions"�"�''�` ,�'�'
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<br /> a'. r. ; :. 7,��� f4..,�:*.�i+=-r:,"r ��;<�•^.• ��.�. z ` 'r+%"�
<br /> ch�may be:�more:rest�Ictive:;tFa�Fl�GounEy i�g�ilattons The��n'd,erslgn'ed�a��umeg:re"s,ponsibtlity for�aompliance;with�:any � ' � �
<br /> �flcable deed'•'re�Nlctions: �:,Y,:;;�:��a�r "� _ • ° ' _ _ _ �-" � :�F�'��`�':. . ,
<br /> - - - -�. ,,;r;r -= - - =`
<br /> UCENSED��"G:ONT�RAC7>OR3��;AND'CONTRACTOR�''RESPONSI�ILI7`I�S.:��'If=.�Fae�}owner�`lies'�hirecJ�`�TM'i;iintractor or
<br /> c o �undertake>wo�k :tNe - `a :'be.:r� ui�.d�toa�e;licens:e°d:In�accor..dance.with:state�:antl:.i.oEai-re ul`allons:=�if°�tFie�-���-=a , ..
<br /> itra t rs`io ,; y:m Y., ,�4- -
<br /> _ _ t .;: �;,_� m.;��.:�rr. :¢x�:���.v.�..�:t_m.�. _ ,9..,,,._ -
<br /> �tractor:;ts•�not.ltcensed".as�re'ulr,ed.=.ti .,-1aw';"both��:the:`owner�and�con4i�acto��me "-�tiewcifeii�'for''���misiletneario�vlolatton
<br /> 4 _ Y .. .�___,_,. . Y
<br /> ler state law. If tfi��owner or Intende+`d�;cantra:�torr�a%e.,uncertalh e8.to wFiat�licensing:�equlretnents:-ri��yr°appljr�forttie:=�-w�>-Y'�°v�'� ,
<br /> x n:�,,...4 .-�•_._. ��
<br /> �nded work;iNe �are:advised�to'contacf�tFie P�as"`co:.'�ouiity;:Building'Inspection:�Dtylsio�icensina�Sectlon at 727-847- -
<br /> Y . � _.. ...�:....._......-....z.t,.._��:...iu ^�.._,�.�.'«'.':a4,Y.:1..- . . .....,. . �. . t-y�+: l. .=t�::.��.,».
<br /> �9. Furthe�more;=�lf�tlie°fovimer-�Na's��hlr�d'�a`contractor'oT��cont`r'actors;-he�is advised�to Fiave°�:ttte contia,ctor(s)�sign.�t,,,+,`.{;^._•.
<br /> Ilons of the"contrector Blo,ck°;.of.�this�application;�for:whtch:they wlll.:be,:r,.espons161e.:;;l�:you;,�as#;the`owner�:stgn��as�the� � � � �
<br /> . . •r , _ , .. . . ... . �._,. ._.�.�..�.�,._. �:
<br /> . __ ,..v ;. .
<br /> tractor, tliat`�iia��6e`an�indication th�t.�he-is not`�'pcopeHy�licensed�'antl-Is not''enti8ed"to`permitting prlvileges,�tn Pasco,, , ,,._ ;� ,
<br /> intY• � • ;_.�._. ,... - - . �-_„ .�_�:_�,:�„� _;;.,:,�.--.L. ,.- . -
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<br /> . , . __,_. .._.___�__...._._.. . ._. ,.._.r ._ . :.
<br /> �IVSPORTAXION�IMPACTNTILITiES<I�IRAC7:AI��;I�ESOUttC'E�R�COV�RY�FEE3:'�Th�under�ig�ed�understands � _
<br /> Transportation Impact Fees�and.Reco.urse Recovery:Fees may�apply�#a tF�e conatruction:of;new;bulldings;;change;of}��°��`�`��'�'
<br /> In exi'st(ng buildings;�'�r�e�cpai�si�n::of`�zi;sti�i�.,b�iitilii�gs;as�specifled.tn P��co'Couoify Ordinance nuinber 89-07 and .
<br /> l7. as amende.d.:.�.�h�.undersigned �I�o�urtde�sta�ds; thsit:`such fee.s;:�as:tnay�;�e:«due;;w01���e identlfled at theftime`�of�''`�`��`x°="'� �. ;
<br /> �: ...•. � , - - . .
<br /> nitting. It Is furtlier'understood that Tra�sportation.Impacf:Fees and::Resour.'ae'�;Recove�`ji�'Fees:�musti be paid prlor to ` ,
<br /> �Iving:a"cerf�icate�oi-occupancy"-=or:flnal�.power_release.���:lf°�the:pFoJ�ct;;does:not�involve�a;::certiflcate of occupancy�o��-�-���'�`°�'��`
<br /> I powec.��etease;„the�fees'-;mu�t_�be=paid�pcior to`permit Is�uance. -Fu�tk�ermore;;�if:,:Pascd�County�'Vllater/Sewer�lmpact<<°�,�°� •.
<br /> �are due,..they must be paid�:p�ior to,permit Issuance��in.accordance,:�wit�;appllcatife.Pasco�:-Countji��ordinances. � '
<br /> NSTRUCTIONsL"IEN LAIN"(Chapter 713,FloNda'Statut�s�as amerrded): tf valuation of work is$2�500:OO�.or;more;:l� •,� < .>;���- �
<br /> ify that ,I,.�he_;�ppltcanf,.,�eve,,.been�provlded->with=-��:cx�py�of::tFie:"Florlda��•ConstrucHonn�:Llen�::Lain�Homeovme�'s , I
<br /> tectlon Guide prepared.by the�Flo�lda`Department of Agrlculture and Cons�m�er/kffairs. If the applfcant Is sotneone ; .
<br /> jr than the"owner", I certlfy�th�t:-I_have:.obt�Ine�4'a�copy.of.the;above:des.crlbed:�dbcurt�ent:antl:pronilse��in;good;,:faith�to. � ,. _.�. ,
<br /> ver It to the:"o � ° �� ` ��.,,>N._:.. . . �:5, ... . . __.. -..,::.:-.:;�_;.�= _,: _ :•.�. .�r ..� . . ,. . .
<br /> wne�-p�io�»to�commenc�merit:`=�-
<br /> NTRACTOR'S/OWN@R'8 AFFIDAVIT: I.ce'4tfyy�t�afi;:all�,th�-,Informatl�Rzl�rj,thl�appllcatlon.is accurat��and that all work
<br /> 'be done in compllance wlth.all.appltcabfe`laws��egula8ng constriictlon� zontng and�land.development. Appllcatlor► Is
<br /> �by made to obtatm:a.permit;to�,do==.wotk�:and:"li�stellatlon as Indlcated:�-:y1.;:cartffy-�tti+at�no"viwo�k'Yor Installatton`�fias
<br /> �menced p�lor to'Issuance of a permlf"and�thaf:all work wlll be perFormed�to meet::stand�rrds�of:��ll laws regula�ing-
<br /> struction, County and Cily codes� z.oning regulatlans� and land development°cegulauons�fn`ytfie,ju�lsdlctfon:�� h.al'so�
<br /> I Ofy that I u�derstand that the regulatlons.of other govemment agencles may�apply;to:the_tntended_work� and that tt is
<br /> responslbllity to Identiiy•what.acttons I,must take:b tie.sln:_corrlpllancs;,,Such:agencles lnclude��but�are<not Ilmtted;to:.
<br /> - Depa�tmenf of E�lvironmer�tal�'PFotecti�i'n=Gypress`.-��Baqlieedg;=Wetland tAreas and E�vlronmentaNy Sensltive -
<br /> Lands,WaterMlastewater Treatment. ' �'` � ������ � ' ' - � �
<br /> - Southwest FloNda Weter Management�:.:I�tsMct Wells; =Cypress•'T'.BayFi`eadg; -=NVetlai�d Areas, Altering - `
<br /> Watercourses. � -�.,. _�_ ...� .. _. . -
<br /> - Army Corps of Englneet�s=Seawails;�Dock's, Navlgatile Wateruvays. �
<br /> - Dep�rtment.of„Health;..8,Ref�abilltattve;Senilces/Environmen#al...He�Ith::Unit�Well.s;:INaste.water��Treatment;
<br /> Septic Tanks: - '" ::'. �: _ '.' �.. '' _ � � ,-- _ - - -
<br /> - � US Environment�l Protectlon Agency-Asbestos abatement.;,;
<br /> Federal Avlatton.Autiio�ty„iiuriwsys:�.--.: : f � - , ._
<br /> derstand that the_folloviiing;;cestrlctlons'apply'to�t6ie�use offlll: . - -
<br /> - Use of flll Is not allowed tn:Fload;Zone"V"unless expressly permltted.
<br /> . _ , T _. -,. ._ .
<br /> - If the flll_matetlal:�;`:I"s�to..:6e;�usedwln�.:Flood�Zone. "A"� tt:�Is understood-that--a dralnage'�plan addres"stng a
<br /> "compensating volume" wlll.be subm�ted at#ime'of_permlttJng w61.ch ts prep�red by a professfonal englneer
<br /> Ilcensed b =.th'e��tate�of;Flotlda;�,-� ��' � . �:�� �
<br /> Y_., ,.. .,
<br /> - , If ihe fill,mateclal�:is�>:to:�;be�.used�In �lood Zo�e 'A" ln5 connectton�Wlth:�a��permltted bullding using stem wall
<br /> conatruction,_I.certify th.at:fill�wall�ti.e used only.to.f111 the:.area:wlthln�the stem:wall:- ._.. �--
<br /> - �If flll-mateilal��l's"'wfo��tie'�used'In any-area;�l`�certify that .use. of such""flll'�av111�not adversely affect'ad)acent
<br /> propertles. If use of f111.1s�found�to advers�l�r,.�fecf°'adJa�nt��properties,.the owner m�y be'ctted for vlolating
<br /> the cond�to�s:of ttie'ti�iildfng�;p�rmlt f'ssued:,under the"`at�aciied�ecmit;��pplicatlon;-for��lots less�than.�one (1) ,
<br /> acra whfch-are elevafeif�tiy,illt;.��renglneered dralnage plan'ls requtretl. ,
<br /> im the A6ENT.FOR.THE�OWNER;�I�rro`mise'�In_good..falth to�lnform the owner ofithe_pecmltting.;condltlons..set forth In ; I�
<br /> affidavlt'prlorto commenoing'constructlb� I"undersfand:.thet a�s�,ep�arat�perinit may be requlred for elecMcal work,_ i;� . � ,
<br /> �bing, slgns�_wells,,.pools,..alt..co,ndltloning�..gas,,_or ott�er_Ins#ail atlons�not.spec�lcally Included�in.the appllcatlon. .A . '' '��
<br /> �. ��-�.-,s ..�,
<br /> nit Issued'shalf tie�.conshuetl�to=be��a`Ilcense:to�:proceed wlth the:;work=and�not_;as:.authorlty to,vlolate;�cancel, alte�, or � � ::� �,,!
<br /> aslde any provistons of'ttie`teofinlcal:�cod�s;�nor shall Issuance�of'a.pe�mlt.prevent the 8ulldlrig Ofitclel from thereafter
<br /> ilring a correctlon af errors,in;;plans�,:;cor�sfi�uctlon,or vlolatlons�of=anycodes: ��very:p�etrntt Issued°��halF.becume tnvalid �=� , '
<br /> ss the.work authoNied�by�sucfi�pe�mlt>�Is.coiiir�ience��virlEhfn�siX.,months=of;permft Issuance, or If work authortzed by �� � � �
<br /> t...:iw4.a �.f...
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<br /> �er�lt I's suspended yor.,abandoned-for�a;�erfod.,of:_slx�(�).:montfi�s�.aife�#he�tlme the�work�ls commenced. An extenslon , `; �;
<br /> be requested, In wGlting;.from the�B�illding;Offtclal for a perloc�notrto:'exaeed���nlnet"y��(90�:days•a�id�wllf�demonstrate ,e
<br /> �able cause for.�the extenslon: If work ceas,es,for nlnety(90)consecuttve:day.s...th�job�ts�constdered abandoned. ; I,
<br /> .. � -� - �._ .�.: _ - .
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<br /> tNING TO OVVNER:``YOrUR:FAILWRE`�TtJ.-:`R�E,GORQ'.A;I�OTI.CE::OF-:CbMMENCEIN�EMT:MAY=RESULT�IN YOUR F � ; ;
<br /> 1NG TWI.CE:FOR.:IMPRO.VEMEN��L:TO�YOUR•:PROPER�TY��I,�;:YO.U�IIV�°iEKID"TQ`;�8�7'AIN�fINApE1NG;'CONSULT �
<br />-��ou�=«�a���a�o�'�ar����ro�tN�������t�s��e��w�vvu�r+t���i�����o����;-=---=-- - - -- — -- ; .
<br /> tIDA JURA'i(F.S.117.03} , . "� . : , � ` .,
<br /> ER OR AAENT ' � . CGNTRACTOR;_ '�..
<br /> xlbed and ewom lo(or afflrteed)before me thls " Subedlbed'and'svuotn=to(o ' rmeslj re.m�fhtB ,
<br /> by :.by
<br /> —� — , .�.,_ .w;.�:.� . . �
<br /> s/are personelly known M.me or•haa/have produced Who:ls/are.p.ersonelty,knowri•to m,'e�.or':tiaslheve;prodi�ced. • _
<br /> ' .as.ldentlflcatlon� '� � � � ' •- � " °'' as Identlfloatlon.
<br /> �. _ .. ., ;_; �
<br /> Notery Publlc _ � Notary Publlc
<br /> dsslon No: - Com�laslon.No.
<br /> o(Notary typed,printed or stamped Neme`of Nolery typed,printed or stamped
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