�� . a K ,�y i�
<br /> N{�'�'ICE{����EID i3ES°ERIGTIQ��� The und�rslgaed under•��and�:#h�t.thi�:•.p�rmit�Km�y.bey�ub�e.�fi,t�;�deed"testrlctions". ,.._' ' ,.
<br /> whlch r��y�be>mar��r��t"r:Ictive�th��Coui�ty��reg�al�tlons,`�The4urider�iigned��s�iimes�responslblltty`'�orscompllaroc�witt��'any, �
<br /> appl6cable:deed e�strlctfo��. :� ,.._ : , ' t _ a _ , .
<br /> �IM�.ICEN'�E�-G�t�'�'RE4C1'�►�t� �Pl� �6�NTt�1GTd�R R���ON�t�I�lTiE�:� -•if the�awner has�hieed .�_`contrac�c�r or
<br /> contractors to undertake work, they rr�ay:b.eur�qulre.d�,to..be:,llaens�l ln:.accordance.with�ta#e.and�Iocal;regulatlar�s:"If�the° � • -
<br /> coa�tr�ct�r ts no# licensed as�requlre���y ia�v,-both•the o�nrne� and-+confract�TB�may be�clted°for°�Tmisiieaneanror vio9$tion
<br /> under state lavv. If the vwraer or 9ntended�;contr�ctor�are,;uncert�ln as to wh�t Ilcen�ing:requireanents.;�;nn�y:_apply:=:�far:�the- > �
<br /> intended e�rk+4ttey a�e advisec!to co�it�ct tti��Pasa�Coum4y,��ailding'In�pei:tlon_R�vtsliin-�lcenstng�ectton at 727-847-
<br /> SvO�. Fur#hermore, if the owaier itia��tili�ed � con�actoT ii� contractor�p he is advis�d ta have �the canhactor(s), sign .
<br /> portla�s of the"cantraat�r Blcook"..��:thl�_appllcaBlan.fur.whl�h they w110.be.r,esponslbl�.- If:yau,:�s:#he owner'slgn"�s tFie �
<br /> �ontr�ct�r, thaE ma�y be an inti6catiora�th�t'he`1s rio�.-prgperly Il��n�ei#-and`�Is no#en#1#�ed �o petiriltting privil�g�s [n P�sc�
<br /> County. , . � � . �, .��.._ . . - ._�
<br /> T�M�F�RT�lT1iDN-1M�at�T/�1T�1�{TIES�fMRA�'�J�Np 1tE�4�tlEtGE RE�QVE�dY-�FEES;�Ths u�tder�6gned"iariders#�nds
<br /> that 1'r�nspartation tmpact Fe�s an�.Reco.tarse i2�cavecy.Fe�rs tri`ay�:apply:tatt�e,construct6on of new buildtngs,:ic�ange�of`�} =�
<br /> us� in ex6sting bulldings,-or�exparts0�n�r of"eui�tin�:�builditigs, �s spealfled.in Pa�co Caunty C3rdlnance raumber �9-07 and
<br /> 90-OT, �s amende�.,,The undetsigned al�o:and�rstands, th�t:�such fee"s,:��is��nay:���.due;s.will:�.be ide�rt�ied at the��tiir9e=,s�f� ,. 4-
<br /> permltting. It !s��tlier understood th�t Transpartatlon Impact�Feea �nd���e�oucce:;R�codery�Fee�.m.u's# be p�ld priar to
<br /> rece�vl��� gc�rfl��at�-of o�cupancy"or fina���caw+�r.r�le��e.� ;if-Ehe.pro��ct:.d��s not lnvolveaa-�cet#if�c�t� pf oc�t�pa�tcy�or=�'�`
<br /> final power-relea�e;,th�e fees mu�t hi� pal�.peioc#o_permi� 0��uance. Fu�kh�rmare;If F�asco;�County"VUater/Sewer,lmpact � �
<br /> fe��aPe due,they.�musl:be;pald:prl�r#o permlt-l�s,taance�ln.a�cordance viilth�appttcabl�Rasco'.Caunty�ort�lnance�. �
<br /> C�N�7'Rt��Ti�N LtiEW'.t.�a�U'�(Cle�pitir T13,�ta��fi���t�tut�����m�nded): if vatuation af woric is$2,ad0.00 or rn�re, F ,, : �;�
<br /> cer�ify that I, #he �ppllc�nt,. have.baen provided wlth-a copy of. the ��Florida �ons4ructlan� Llen:Lav�--Hameowner's
<br /> �ro�ecti�n t�uide" prepared by-tlie Flo�ida �}�pa�tme�#�af Agrlcu[t�re and ConsumerAftatrs. If the appttcant ts sarr��o�e- .. , k
<br /> other tha�the"ow��r", I certify that I h�ve,obtain�d�a'a�py;of.the:a�bove..d�s.erEbed document�and-.p,romisi�.in,gaod:,f�ith�to
<br /> deliver 4t to the.,"owne�';pr.ior lo�c�rnm�riceirse�E:':' . _.. • .
<br /> C�NTi�►GT�R°�r�VVIVIER'��F�B��VIT; I.cert9�y:#hat�all�th�=;6nform�tltm,.i�a thi�apptlaatlon is accur�t��nd thaQ all work
<br /> will'be done in c�mptian�e �ith aII.�ppUcable�lauvs regulating con�tructl�n+ zor��n�and land�developr�e�rot. Appltcatlor� is
<br /> 9�ereby �aade to obtain .a peconit:to do,work�;and in�t�llatica� a� tr�dl�afed::�...:t c�rtifyr �hat �o wisrk��:or Installa#ton h�s
<br /> commenced prlor tv Issuance of'a per�nit"and that all work wlll be perFormed to me�et.stand�rds�-of all lauvs regulating-
<br /> c�nst�uct6�nt Couatty a�� �ity c�des, z�nln� regul�tic�ns, ar�d land d�v�topr�ent r.e�ulatloiis�in the:jtarlsdt�fi�n.- 1 alsa
<br /> ceP@Ify that I u�derstand that th� regulations of�ther ga�vernment�gencl�� rnay��pply�#o the.Int�nded work, and tha6 it is
<br /> rny respo�sfbllity to Id�ntlfy.what.actlans 1 must t�ke;ta�be,ln;.co[rtplla�ce._.S,�a�h ageracles f�c0ude bu#-�r�.nat lfmlted to:
<br /> - Departrre�n# of Erlvironmental�i�te�timr�-�pTB��.`��yI188d�� VV�Nand Areas and Envtror�mentaliy Sensitive
<br /> L�nds, W�@�er/VN�st�wa#er TraatrnenQ.
<br /> - S��t6�uvest �I�rida VV�ter lVlanag�ment� Dfstr�ct-V�e#Is;` �yYPress� Bay.heads�, �tV�#�and Areas, A1te�ing
<br /> VVNater�ourses.
<br /> s Artny Gorps�f Englne�rsSe�waNs,[7ocks,�lavlg�b�e VVa#e�n►ay�.
<br /> - Departrre�ent of.liealth'.� Ret��biiita#id�,,.Se�vicesi�nvir�nrnent�l-He�lth Unit Vileli.s� VVastewat�r=Treatment,
<br /> Se�tic Tanks:. " - ,�
<br /> - US E�vieonment�l P�otectio�Agenccy-Asb�st�s ab��ement.
<br /> - ��deral AvlativnAt�thorlty-f�unways.
<br /> 1 und�rstand.tha@ the_�ollouving;a�estet�tlons�ipply to the use of�lOh•
<br /> - Use of filt Is not allowred ir�'Fload:Zope"V"uniess�xpressly permltt�d.
<br /> - If the �fill rnateri�B-�is to �be us�il..In :Flood Zone. "A"� IQ_ Is understood th�t a dr�Inag�a plan addre�str�g a
<br /> "compensad6ng volum�"�rili be �ubt�#tt�d a#4ime� of;perm6t@ing�lilch is prepared by a pr�feoss6ona) engineer
<br /> Ilcen�ed by�#he�tate of Florlda:
<br /> - If the #ill rr�aterial�is to:b� us�d �r� Fiood �or�e "Aa° In�cann�c�lon�w�th:a� permltted bu�ldlt�g tasEng ste�m �nrall.
<br /> � construction, I certify th.�t fiil�:v�Jll:be-used onfy to.fill the area wlthln the�stem wall.
<br /> • !f flll m�ter�a! Is to be used tn �n� are�� F cetQlty tttat .�s� eaf s�ch �!1! w111 n�t adv�r��ly affect adjac+ent
<br /> prop�rties. If use�f fili is found�to adver��aly:�f��ct��j�eer�t�pro�erties,,the er�ner may be ci#ed for v0olating,
<br /> the cor�dl�ion� of the bullding:p�rmlt Issued und�r 4he.att�ched p�rmit applicatlan, for�lots-less�than.one� (1)
<br /> �cr�whtc�are eEeiv�ted�6�v f#11�a�ec�gineered dr�ie�ag�pl��a Is re��tred.
<br /> If 1 am the AGEPI'�"�OR TM@ AYVI�lER;_I,�pramise In go�d falth to Inf�rm th�omvner of-the permltting cor�dftlons s�t forth in
<br /> this affida,vlt�prfor ta conr+mencing const�uc4�on. � a�aeTst�na t�,at�Yseparat� permlt m�y be r�qutred for e�e�t�fica# wrasrk, , .
<br /> plumbi�g, �igns, v�+ells,.pools;. �ir es��ditiorring,.g�s,_or other tnstall�tions nol.spec�i�tly inciuded�in.the appiication. �A
<br /> permlQ I§sued shall be canstraaed to be a� lic�nse�•�m�proceed wlth�he work an� not�as:autbor.i�r to.vlolate, cancel; alt��r, or
<br /> se#asid�any�rov�s3an�of ttie���h��cal.cod�s; nor shall 6s��ra�c�of a.perm6fi.pceve�rot the�uitdirig t�ici�tf�rn there�f�er
<br /> requlring�c�rrection af eRor� ln•plans; consCr'uct0an.or vlolatl�n�o�'a�ny�od�s: �v�ry��p�rmlt lssu�d sH�ll�become�invalid
<br /> unless the�ork��atti�rlxed_by st�ch permlt°��-cmcra�enc�d�wlth6t��f�C.month� ��permlt lssuaa�c�, ctr �f t�rark authrariz�d by
<br /> the permit fis susp�nded�or.aba��doned-for.$:period;of si�(�B)manf�s.-aft�r 4h�ti��the�watk�is comnnenc�d. An exter�sion
<br /> may be requested, In wr(ting, from 4he��ullding,CJ�filcl�l f�r a ��rlod-not=to exceed�reiru�ty�(90) days and uvilf deciiionstrate
<br /> ;ustl�iabl�cacase f+�th�e�ensia�: tf work ce�s��:far ninety�90}�ons.ecut�v���ys,..th��ob�is cae�sideted abacadoa�ed.
<br /> �!l�lRd�ll�G TQ �1M�l��; Y�t��..��a1�.URE T0..1&E�.Cltt� �..lNQ�1C��:��':�G�M11111�i�l�I��IElitT.��Y=�ESt��:T I� Y��R
<br /> P�aYON�`�ICE��'OR 9�i�0'Ii'l�li�l�IV.����:1f��16i:P���D�ER°�d: I��Y�.�1=1t�'�E1�D�TA►���7"Alhl���'l1�iN��NG;'I�.AN��9P T
<br /> 1PV0'�'�i Y�1d�' t.EWC�@lt.�„�'1fS E#i�_��T�31RN�f'�'�I��m'����A�'�����%'l�011l�r:�,T���''�?�°!�Al�����.l��a���,'�r.--
<br /> - - . . - - - _^- �
<br /> �«��c��,��;�;-��,�:�.�ra�}�__ _ � _ _ - -
<br /> �QIf�NER OI8 AOENT COtdTl81�CTAR
<br /> S�bsaibed and�wom to(or ai�rmed)b�fara me fhls Su6sctibed and'�m�4a(of af�rmsd}�befote ta�e tliis
<br /> by .by . ..
<br /> Who Islar�petsonally knovm to.me orhas/haba peoduced Who.ls/are per�onalty known to mg_or hasA�ave�produced �
<br /> as td'en8�ce8an, � ' as Idert�flcatton.
<br /> tdotery Publ►c _ Idotary Publlc
<br /> Cammissta�tda:` Comn�{sslan.P�a.
<br /> Name of�iotary iyped,Ptin�ed or stamped �fame oi tdota�r typed,pr{Med ar st��ped
<br />
|