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<br /> OTICE OF�DEED=R�BTRICTIO�IS: The�underslgr�ed�rwnder�tt�n. wth�itfiF�ls;:p@�mi�: y,;;,,, ij,� t�..deed �res.a�ctiori§., '
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<br /> fiich may.ta�e;�niore�re�ti�ict�ie;�#he��untji{r�g�i1'a4�o�s� SThe,r�rid�rsigneid as�'umes�regp�n'�1�111Cy.for�cfirinpilance w,itfi,-�riy�
<br /> PPlfceble�:deed�sest�icttons. ° .,,: - :,,�;���.;��:����� „�- , -.�,r��.��,.;`..�,.:�-�, .
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<br /> NLIGENSED:�r'GCEN"fRAC�tt$�:ANQ'�CON�'I�ACTOR'':RESPO�+f$1�11:lt1��.�.,_..I����lie==oi�es=:��h�is�'4h3red.�•i��-i�t`itrai:tar.or.
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<br /> �ntractacs�#o.undertake wark�..the ma .`:be`�.�ei ufi�+s.dd�o-��e�l.lcerised:`'ln�.aiccor.dance:wtth:st�te�.anil.local<.r.e"�ulallons�;`�If�tt�i�a��=��_:��:-; �
<br /> ;._ -Y-�,..:.Y'. - ..q ;,�-.x :,, _ _r:�;p :n. _ ;�-:�X:.�.���}<.�:,,r. _,t,.�:,�,,..,.� _ .�,,. _.9
<br /> miractof.`:�Is�=not°:llcen�ed;°a"'s'regulredktiy,;laiw;:�tiotfi��the,ouv�i�r,andl'con�rector�ma�r��be�clt�d�;fivr=°�i�misdemeaiior�-ydolatton ,
<br /> nder state law. if the�•+awner ar Intendedl:con#r.ai�tor•ece;�uncertatn�a's:#o wfi'a ilcensin �r ulre�nent`s,�ma. _}��.t�;~�r.�:-'', .
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<br /> tended work�tM are�.advisetl'ta;i�irit�ic#�he'P�sco:.�ou�iy.:Bui�dln Ins`ection D�itsion:-=�,t:icensi� `Sec#ion.at`727-8d7- ,
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<br /> �nlons of the co�tr+�cto�8lock"_:of_thls w Ilcattan_afor;whtchsthe.;wlll�be:responsl6ls.,::l�:. .ou,�gas:.fF�e,own�r stgn-as"� � `"f ``=" .
<br /> a0�. Fu�thetmare;If�the�owner�l�as,.tilretl`a�Ycoi�tractof�'or��corttractois, ha.is advlsed`to-have;_the .cantracM s,;_s ,
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<br /> mtractor;.that`tri` .'be an Indlcatlon that-iie��ls'rnatr:prope�ly�llcen�e`d��anii�-t�'`'ri�t"�ntltled'�b pe,'."'�"-�'�T`. �'r�4v�'�``� '�
<br /> a�c: " , �� rmlttin�°privlleges'�In Pas.co �
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<br /> ounfy. ° �,. �. ... . ._�..- .,i;,. �...,..te..,.:Y � ._ ,.., . �. �j
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<br /> RANSPORTATICiN.IMPACTItlTli:�'iES�1MPAC'�'riAl�b�#�SOU�tCE RECCiV�EtY=�EES:�Tit�°u�dersi��ei�'understands ;
<br /> atT�ansportatlan Impact Fe�s.snd.Recn.urse Recavery.Fees.mayaapply�:tathe conshvc�on.of new;.4u11dings;.fchange�cf"�°��';"�:,���- ``�
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<br /> ie In exi's`t(ri tiulldln�,s;:.a�r;;ex � nsl���t.ot�ei�sti'";_..�b�lldl�-s; as`s'ect�ed:In P�s�o�Coun� O�clfn�rice number 89-07=and �,
<br /> �, � .�. �; � � $..._,.. � � .
<br /> )-U7, as amende,d�:.T;he� underslgned �Iso�understand�, thgt°suc�h fees„as�tna�r��e:°duent�rpLtiDe Iderit�ted at the=tlme=�of�s�--°�`�~,=�-'=°�=
<br /> �rmitttng. It ls iurttie�'unders'tood that Transportetlon�lmp�cf`Fees and=>Resowr�_Rei�oifery;�'�ees:.inu�t be pald prlor to _ �•{
<br /> C8iVi11gS:'C81#MC818��.oioccupancy"�or->flnat��.pawer�retease:;•:If�'the:proj�ck�do�s:ridt.lnvolve�a�=:cert�icate'-ofoccupaiicyi:�or���i�����;�:;` F .
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<br /> ral powerv:releaseR=#he::f�es?�:mu9ft`.��i'�paid�pT�or:t'o"�permit iss��nce. .Ftt�t�iermore;:�if:�Pasc+�r•Cs�unty�lNater/$ewernimpact:��;:� �,�,�.: .
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<br /> es$re due,t�ey must�.be�pald:prlar t�>permlt`�Issyance-�n a±�cc�;clance wif�r;aPMtc�ibte�Pasco:Caunty�ofdinances.
<br /> �N�TRUGTlaN'L`!EN'°#�i1P�{Cli�ipt�ir 7i3,Flor�tla'Statut�s,�am�n�ed}: if vsluatlon of;wark 1s 52;500:OO�or:more;�!_ ; �.::r.;:K�
<br /> �rtify that,I,.,�qthe..;aPpllcant;_��ieve•�b�en�.,:provldetl.-�with,.a=�cflpy�of:�the.,"Florida•�Constrti�ctioti;yLlen.::law:Homeowrier's
<br /> rotection Guide" prepared=by�,tMe FIo�1�da�Qepi�rtmenf of Agrlc.ulture and Cotieum�erA.ifiatrs. If the �appllcant Is,someane..;,,. :__�.�:,
<br /> her#han#3�e"ourmer*, i certify.{ih�t�t-have.,ob.f�tne���coPy:of:the�above:des�ctt�ed�dbcuw�entsand;pmr�i"se;ln,gootl„falth to� �. .
<br /> 91�Y@P 1t tt?:t(.{BraOWGtB r.f,;}�i{IOR'tdFGOtiIt'FIBTIC@EiII31Ii:�r ;��:';:`' ` , �,�:: •_+�._ .,.., c':-� . Kc,,:,.;,<.._:,.c.'". . '`" -.. -,._ „
<br /> ONTRACTAR`S/QWNER'��AF�IDAYIT:. 1.cert#fy..tkt�t=ef�:#he-,ln#ocmatfm��i��this:appllcatlan is accurat+�;�nd tha#aN v�nrk
<br /> il!'be done in compliance w(t� all.app!lcable`laws�reguladng constnia#lonr zontng and,l�nd�,devebpment. Appllcatbn Is ,
<br /> �reby made,to._obtat.n.-�a:;:permit.trto;,do;;wo't1�;:,�nd:�lti�tallatton as indlcafed'aR'�'T';��"4ectlfyytFiat no work"�Eor, lnsEallatlon`lias°
<br /> �mmenced'p�io�to'Issuance of a.perr`r�1t�and�thaf.a�ll�`vi►ork wlll be perFormed�to meet.�;stend�c�cis:of,_�II I�►ws regulating-
<br /> �nstrucBon, County and City codes, zoNng regulatians� and iand development°regul�ttans��In°tFi`e`;Ju�lsdtctlon.�:�=;1:a1'so°°� .
<br /> r�tfy tha#1 u�ders#and tha€tlie regul�atbns of other�gava�ment aget�cfies may�epply�=to..the_.intended work, and that it is . �
<br /> y respon�fb!lity to Identify.what,actioits�l;must�take:#a 6e,tn.,c�nlpltar�ce.F Such;agencles°include bi�t�are:not limited.ta:, ;• �- � ,:
<br /> - Departnie'nt,of�E�vlron�neiital��Prot�`,i��ii��Cjrpi�ess:8�iylieads�;�'VU`+�tfarrd�Areas.and Ernlronmen�liy Sensitive . ;� '
<br /> L.�nds,VUeterMl�stewater�Treatment. ' ' rv , �
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<br /> - Southwest FloNda Water IVlanagemenE.;.:l�tstrlct Wells; �Gypress. .�ey��ad�r,� °WeQand Areas, Altering �
<br /> Vilatercaurees. _ .. . � - . � ,�i �
<br /> - Army Corps of Engtneei�s-Seawalt`"s;�Do�lcs,i�avtgabte Wa#ervirays.
<br /> - Department of .l�lealth,,;�;Ret�abltitativ�.,,Servlce.slErnrltorr,men#aI:.N��altli.lJnit:Vilells; :'ll�astev�ter..Treatrrierrt. �
<br /> 'Septic�Tantis�:.�,�.<r' - � �, , ._.. .. , � - _ � . . ..
<br /> - US Environmental Pcotectlan Agency-Asbestos atia#ement._ .
<br /> �...Federal Avtatlon;;Auihorlfy�;Rumvays:;;_. . ;_ . � ; .,
<br /> nder3tand that the:foilo�ifng;:restrictlons�:appiy'#athe�use offlll:� -�
<br /> - Use afflll!s not-aAcwed:l�Flooif..Zone"V"-unless expressiy4perrnitt�d.
<br /> _ If the:;flll.,matetlal�:Is'�to,Ube'��use�:=[n:�Flood_F.Zoi�e. °A","!t {s�undersfood�that-a �dcainage�plan._addressing a
<br /> "compensating��Volume"wlll be submitted �t�me'of pet•mitting wfilch is.prepared by a professionel englneer
<br /> 11cen�ed-by:,th'e.<<�'tate�of;�FloFlda::,- .�. . . ; , .
<br /> - , if ihe flii.:materlal���i�>�to;;be used tn �io�d"Zone 'A" lns connectior��w1th`:a��permitted bt�llding using stem wa�ll
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<br /> constn�ctfori;_1 cetEifjr th�t,#ilt:�t+�ll:ti.e t�sed oniy.#o fill th�..acea�within�the�s#ettn:wali. �. . . ,.,.
<br /> - !t afllC4matieila!"'Csv��to=�tie=�used:�ln:•anjt,a�a;�°f�+cet#tty #hat .use. af su�`fitl wi11`r�ot a�hrerseiy affect adjacent
<br /> propertles. If use:of flll;Is tound�.to adYersely,,�ffect�'a�lacerit��prctpertfe��.the awner may be cited for uio�ating. '
<br /> the cundEtions'of ttie bdildling�;permtt lssued'vnd�r the��at�ctied.�ecmlt�applicatlon; for�lots less-than:one {1)
<br /> ar.�e�whlch ai�el�vatetl bjr,fllt;.�ct engtneered dralnage plan�(s requlred. �
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<br /> am fhe A{�ENT,FOR�THE�OWNER;;�i;�ironitse'tn,good faith to�l�#orm the-awner:afi:the_permlt#1ng condlt�ons set forth In �'
<br /> -�,.:.,,.:,._:..., � '�`�; ;
<br /> s aitidavit`priar'to+cor»me�acing constiuct�on !understand�that�s�;�parate�permtt may be required for etectHcai work� ;.;
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<br /> imbtng� signs�,wellsr.��ools;.alr co�dttloNng. g�ets,,or ott�ec.lnstal���tans"not.spec�tc�al�r incluzted�in.the appiica#lon; .A� �
<br /> rmit Issued'��tiaU be�"co'ns►trued to�be a�'lt�ense�to;proceed wlth�'tlie`iivoik acid nah�.as;.�uthorlty�.to.=,vblate,:�cancet;,slter. or �� °°�;
<br /> t aslde any�provistons-of t1i'e:tectinlcal:code�;�nor shall Issuance�of`a"pe�mlf.pr.event tt�e Bulldlrig Otticla!from there�fter �. Y'
<br /> �uirEng a correctian-af errors�in�:plans,.;cortstivctlon,or vialattons�of°�ny-cades:-��very.�p�ermlt�ssued=�hall:becc�me invalid � ��
<br /> �ess the work aiitiiorized l�yi such pertriit:�is.coxiimen�e��within.s�c,-months�of:permit Issuance, or if work authorized by °' �
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<br /> 1 permEt is suspendgdYor eba�do�ed.�for_��:�.ertod;oi�.slx{8):mont�is;;af�the tlrne•the�wat�k��is commehc:e�. An extension '.;,k ;
<br /> iy be requested, In wciflhg, froin the�8u11dtng t3ifli�lal��for=a patliid::iiot�-i'o.�exc�ed;rnlr.ae#y:{90)��ays.and.wlif damonsf�ate L:f i
<br /> llfiable cause far�the extens(oriy If'vuork aease�:for nlnety(90j cons.�cutive:day.�,..the�ob=[s�conslderer!abaadoned. _ ,�: �
<br /> iRNING Tt)'�1VYN�I�.�s��YOU ,�� i ' Y ' - `", �; ..x.�,. .,_�,,_. -.- ... . .:. ,. " _, .� �°�� 1
<br /> T R A LURE��Tt�l.�fitE�:OttD�;:A:::l�[aiTf�CE..OF.C�MMBMEEMEIV'f:�NtAY�RESULT�IN•�YOUR. . ;
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<br /> NLER OR A08NT CCINTRA�TO�� - - - ---
<br /> saibed and eawm M(or afflnn�sd)before me thl� ' ' - Su`ecrltied' 'nd'suro �to afllrmed)'¢�fore�e th�
<br /> by t3 v,:':t-'tS�:. a. - s' ,
<br /> �Is/are personally knovm to.me or�has/have produced Wha:tc%€e� e atly .ov.�rt•ta m. <or.liaslhave.,pradiaced. .
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<br /> tie ol`Natary typed,pdnted or stamped Name of Noiary p'm� �
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