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9��'fi�C��(� D�f�D 1����'�9��92DV��: Yh�und�rsign�d und�erstands that this permit may be su�ject to"cf�ed" rest�ictiaois" <br /> w7�ich may be mare restrictive than County regulat:ions. Th� ui�od�rsigned assum�s responsi�iility for comptia�nce wit� �ny <br /> applic�bi� deed restrictions: ' . <br /> 49E�iL@C��H�I�D �+t�6�S`CB������� 1��8� C���@�+�'�'tPft� �l��f���d�8�39[Lg�'0��: If the own�r ha� hir�d a �contractor o� <br /> contrac@�cs to und�r�aRce wor9c, th�y r�aay b� r�q�ir�d to t�� ltc�a�s�d In �ccard�nce virith �tat� �n+� loc�l r�gul�tions. 9f Qh� <br /> ccantrac��r is nok lic�nse�i as r�quirec9 by iaw, both the awner and contractor may be cite� foa� a misdemeanar violataon <br /> undeP st�Q� law: If th� oitvn�r ar intec�d�ci contu-a�c�or ar� unc��fain �s to wh�p licerrsing requ3rem�n�s may appty f.or �h� <br /> in��nd�ci work, th�y are advis�d f� contac#the 9���co Counfy�a�i(ding Bnspe�tion Division—�ic�r�sing S�cfior� at 727-8�7- <br /> 80�9. ��a�thermor�, tf the �v�rn�r h�s hi��d � c€ie�tract¢�r �r �onfr�cfe�rs, h� is advis�d tc� h�v� the c¢�n@ractor(s� sag� <br /> por�ians of Yh� "�mr�t��ctor �lock" of t6�is applic�tiara for whi�4� �k�ey wi99 be.r�sponsible. 1�yau, as th� owner sign as �he <br /> cor�tracQ�r, @hat may �� an indic�tion �t��� h� is ncpt properly lic�nsed ao�d.3s not entotled to ��r�ti@ting priviier.,�es ir� Pas�ca� <br /> Courtty. . <br /> �'�V����D��'�`Q'6��f 0����`P���'��9�'81�� 8���1��'���ll ����,D���� i�������Y����: The unde�sig��t� unders�ands <br /> fih�t Tr�nsporfati�n 9�tp�ct F��s and Faecaurs� f��cov�ry �ees may apj�ly to the cortstructian c�#new bu"sld'sngs, �hang� o� <br /> tas� ir� exisfing buiidir�gs, ar expansio� o� �xisti�rg buildin�s, as sp�ci�i�d i� F�asc� C�us�ty �rd4nanc� n�mb�r.8�-Q7 and <br /> �0-�17, �s am�nd�d. Th� ur�d��sign�d alsa und�rstands, that such f��s, as m�y 6� due, will be 6dentifi�d af�he tim� of <br /> ��ru�niQkie�c�. Ik ts fiurth�r und�rs��rnod thu��Yra�spor@ation Impa�Q Fees a�ad Resource Recovery Fees mus� b� pai� prior fm <br /> rec�ivio�g � "cerfificaVe.o�occup�ncy" or final powa�r u�el�as�. I�the project does nof involve � �ertificate of occupancy ar <br /> fnal pow�r r�i��s�, the f�es rnus� b� paid pPiar �v permit isscaanc�. E'urtfi�rma�e, if �'�se� Caunty Waf�rl��uv�r 6mpac� <br /> f�es �re c➢u�, th�y must be pai�#�rior�o p�rmit issuanc�in�ccordance wi�h�pplicabl�Pasco Caunty ordie���rces. � <br /> ��G��'8'�t�tC'P���H �.41�8� �.��49 Q�O���n����'��9 �D��9�����Qaa���p �� �r����l��9}: I�v�luati�n�f woe�c is:�2,5Q0.�0 or mor�e, V <br /> cer9ify khat 1,- th� �pplicant, h�va b��r� pr�vid�d with a copy of 1he "Florida Construction Lie�n Law—@-9om�ownE:C`5 <br /> �¢�ak�cao�u� Guid�° prepared by �6�� �lori�a D�paPtvn�nt �f Agricultur� and Cons�am�r Aifairs. I�Qhr� a�pplic�n4 is sorr��ane <br /> oph�r t@�a,n the "c�wner", I certify �h�f I have ab#ain�d a copy of Qh� above d�s�rib�d document and promis�in good faith to <br /> d�96ver i�t�the"own�r" prior�o c�unm�ncemen�. <br /> t����'ti����'B��'�1��G��(�'�d�f�9���t��8�': 9 cerQif�r tha# a41 fh� iriforma�t'son in 4his appiication is �ccur�te and that �!f wor#c <br /> wili'b� dar�e ie� ��m�iianc� vu�th all appiic�bt� taws e��gulati�g �onsQruct6on, zan€r�g �nd lar��9 d�veloprti�nt. Applica�ion is <br /> 4��r�by rraad� �o obt�ie� a permit ta� do woc�k �nd insQall�4ion as In�ic�t�d. 6 ��etify tha� nc� worlc or in§talla�ion h�s <br /> c�lrnm�nced prior i� issuance �f a �er�nit �nd qhat all wor8� will b� perf'�rmed to rri�et st�ndards �f all I�ws r�gula�ing <br /> construction, County and City crvdes, zoning reg�ulafions, and land d�v�lopment regu(�Eians in th� jurisdicfion. P a}so <br /> cerQofiy th�t 1 und�rst�nd that th� r�g�¢lations of o�he� g�v�rnm�rrt agenci�� m�y apply t� th� in��nded wa�r6c, and �hat ifi is <br /> my r�spansibilify#o id��fify wh�fi�cfi�ns f r��sf t�lc���be ir�carnplianc�. 5uc4i��encl�s inciud�-b�k�re not Eimit�d to: <br /> - D���rfm�r�t +�f IEr�v��e�nrn�n�af ��c�k�clior�-Cypr��ss �ayh��c9s, We�l�nd Ar��s �nd �nvir¢�nm�r�t�lly ser�sitiv� <br /> Lar�ds,VIIBt�P'/W�SI�W�gLP TP��t[Y11�P1�. <br /> - Sat�thw�st Florid� �11�ker BVdanag�un�rrt D'is9ric�-W�IIs, �vpress �ayh�ads, W�:flas�d Ar�as, Alt�ering <br /> Wa4ercouPs�s. <br /> - Army Corps of�ngin�ers-S�aw�lls, H��C�CS� Navig�bi�Wat�rvtrays. <br /> - t3epartm�►�t of �I�alth � R�habilitafi�r� S�rvices/�nvir6nme��ai �deat�h Un9t-We�ls, W�stewate¢� Tr�atm�:ng, <br /> Septia Tanlcs. <br /> - l�S �r�vironrr�ent�l P're�fe�tio�Ag�ncY-Asbestos abat�ment. <br /> - Federal Avi�tion R�u�hor6@y-9�unways. <br /> I utn¢9�Pst�,nd th�t 4he following r�:s�rictio�s �pply ta�fihe use of fi10: , _ <br /> - Us�af fll is not atiaw�d in �lood�on�"V"unl�ss expr�ssl�I p��qnift�d. � <br /> - If th� fill rnaferial �s to �e us�d,in F1ood �ane "A", it ss u�derskood that � �rainage pian addr�ssing a <br /> °eorri�ensating valu�m�" will b� sube�itt�d at ti�ne �f p�rmott�r�g wk�'sc4� is peepar�d b�r � p�of�ssi�nal �nc�ineer <br /> 4iceriset9 by fhe St�t�of Florida. <br /> - !f fihe �il! rr►aterial is to b� us�d in IFlood Ze�n� "P�" in. c�nn�c4ian with � p�rmift�c9 building usbng sQem wall <br /> cansfruc�ion, I cerQify flhat fill will be used only#o-fill�he ar�a wifhin the sf�m wa(1. <br /> - If fill material is �o be wsed in ��►y �rea, 1 c�rtify th�f �ase of st�ch ftl 'vuii! �a�� adv�Psety �ffect ac}jacer�fi <br /> prop�rti�s. if us� of fili is �'ou�d #o �civ�rs�ly affec# ad�acent prog���ki�s, �he owr�e� may b� �it�� for viola2in� <br /> 4h� co�di�iar�s af Qh+e buildang p�rmik assu�d tandeP the akk�ch�d p�rmit applica�ioa�, for l�ts less �han one (1) <br /> ac���nrhich are el�:vat�d by fi!!, an�c�gineered drain�g�pl�n is r�quir�d. <br /> 9f @ �rr� Rhe�49(E@�� 1����H�� �4�9���, ! �ar�mis� in good fai�h to irafo��n 4h� owrr�r ofi th� p�rmitting condifio�s s�t forf(n i� <br /> this a��Fic4�vik prior fo corrnmencing construcfia�n. I und�rstand fhat a separake permi� may be reqc�ired for et�cfeical wor4c, <br /> pltarnbing, signs, wells, paols, a�i� cor�ditianir�g, g��, or �sther ihst�llat9oros n�t specifi�caiiy includ�d in th� apptiicafion. ,� <br /> p�rmi�issu�d sh�ll be constr�ed �o b� � lic�r�s� to p�oc�ed v�ri@h th�worlc ar�d rso4 as aisthority te►.violate, c�ncel, al@er, or <br /> S�Q�S6t�L' �tiv �3POViSIdFtS ���E1G��{��IF19C�I G4t��S, ��o�'�Pt�l6 issu��tce�f�pe�mit pr�ver�t th� �uildi�ig 06ficial f�om th�reafit�r � <br /> ��c�uirir�g a coP��ctiort of ecrar� itz p{ae�s, cansfrtacfior� �c viol�tior�s of any codes, �v�ry.permit issued shali b�corne invalid <br /> tsr�l�ss 4h� v+rork �U4horized by :such perrniQ is con�menc�d wit�iin six rv��nths c�f p�rr�it iss.uanc�, i�r i�work �uthoPizecf by <br /> �he perrr�it is suspend�d or�bandoned io�a period of si�t(6) me�nths af��r�he�im�th�woPic is corrim�nc�d. An ext�n�ion <br /> rr»�r be request�d, un writing, fPa�m t9�� �uile9�ng �i�iei�l f�r � peri�d ro�q tm �;xce�d ni���y (�4) d��ts aetd wi9O dem�nstp�a4� <br /> - __ - ➢,�s?ifia�bi�:�ause-for fF�e exfe�t�ic��t. Pf�vorlc-c�as�s fo�riieseky_(9Cf}cons�cutiv�days, 4h�jr�b is cons6d�red ab�r�daned i.— <br /> �d�1���9t�� T� CDY4�1��f�: �f��D� ��B�4Bf�� YC8 ��C��� � �➢�T9C1� �� ��B��d�P�C�ti�f��'�" 6if��� ���alIIL�' 8� �°�I�Q9� <br /> �1��9�IC��1`�P@�[E �CD(� 9�`�tlf�f�9��191�U�{dfE6�Tf'�'�����.0�_�'f������. 0�1f�D�D 6��'E�D'Y� ���'��Va9 (�Ei�a��9�G�i�, t��61h�Q9�"�' <br /> �4�9�TIF8 if��9���6��[ER�ll���1 A�1rY�ff�V��Y�[��t��� ���P,��It39�9��f�i111�$ �9��'B�� �(�G�D�Ii���d�I�E�t��9�'. <br /> �LOR1D1�JUi�AT(F.S, 117.03} <br /> �vasa���a���,���r� �Q3Ni'�C'��9� 1� tC.l� �1 �. C�'y�p ��-t . <br /> 5ubscribed and sworn fio(or affirmedj before me this S b �ibed and swarn {or a�rmed�before this . <br /> by � , <br /> Who is/are personally known to me or haslhave produced Who is/a�onally{cnown me ar haslhave produced <br /> as ident4ficafion_ as identifir,ation. <br /> ��O - <br /> Nakary Public P�ofary Publia <br /> Coenmissian i�a. o m!s on Na. s��.PYpV^,,,, <br /> 3'; '`z MY COM1v21SS1QN#FFt44$17 . <br /> �tame of�otary typed,printed or stare�ped Rlame ti(tlotary 4yped,p n¢�F�r,�'a1np�KPlRES July 24, 2018 , <br /> (407)398•D153 FloFidalloteryService.com <br />