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<br /> N4TlC�bP DE�p R��7RiC1F1oNs: The andersigned understands mat ktus permk may be sabject to'tleed"r�estricEions'
<br /> which may be rnore r�strictivc than County regu�aEio�s, 'Fhe undesslgned assWmes re�ponsi�itiiy for compC�qce with any
<br /> appsicab3�tte��res#rictions. !
<br /> UNLICENSED CONTRACTORS AtaD CpNTRACTOR RESP4NSIBILiT1Es; If the owner nas hired a contractor ar
<br /> eonUr�clo;s fe U�dertaKe work,tF�ey may be rpqe�jred to be licensea in arcord�nce with st2te an8 locat reguEstions. It ine li
<br /> conVBCtor is nat 3iaensed as reG�tred by law. battt the ow�er gn�x tontraaoc�n�y �e c;i�cf for a rnlsdemeanot vinla#;acs ;
<br /> ur�ier sta[e iaw If tha owrmr or mtentletl coi�ttaGtor are uncerta n as ta wna[iicensing requiremen�s may apply for the �
<br /> intCnd9d work,ttsey ar�ativia;t;rS to cantact�he P�sGo COunty BuilU��g li�spectic•n LTivisi4n...�LiG2t�sirtg SpCtiqn at�27•Y�7-
<br /> 8049. F;,ctr,ermore. i�the orvner t�es P�ired a c�antraaar v�ctsnttaaars. h� �s advised Eo have !rie �ntractor{s) sigt7
<br /> poriiqns of in�2�conna�tor S�ocX"at tnis appiicatson tor whiah tt�ey�viii pe respoRs�ble. If you,as tne owner sign as the
<br /> conus�t4r.21�ai m2y be an ind{q6trotl that tte IS Ytot propa�ly{icen.sed end�s rIU!C�hlitled tv g8rmittittg pfivaii�ges in P3sco
<br /> C4unty. `
<br /> 7EiRht$i�DRTATIUN�CVEPACI'NTIL11'IES 1MPACT ANO FtE$OC��G��iEG01�'ERY FBES: 'iPte uAtler5ign6d uRdeYSt3riQs
<br />, tr�at 7ranspprtatidct Impa�t Fees and R�Coutse Recovery Fees m�y sppty to t�e t�nstru�kfqn oi new bui�tlings,c�ange of '
<br /> use in extst'.ng�t,rtdings,or exp�nsson oi existing Duiltlings,as spes�ed;n Pasca Gounty Qrdinaace number 89-0T and
<br /> �JO-07�as 3m�ndetl. frit�uardersigc�t*r��s1;,o und�5iaridS.t�t Suc�tge5.85 fi7�y b��u2.wi�I b2 identified 2t t�1e titrt�pf
<br /> pertnitGng. It fs further understood tt�at�ransportatian lrnp2ci`aes and Rasparce Recov�3ry Fses must tr�paid pAor to
<br /> r�ce�u�ng a��Certi�c�te of occupanc�'of final pqwer r�1��se. kf the projeCt ddes not involv��cerkificate pf oecup�n�y or
<br /> fn�!power r�(ease,the fees cnusf be paid prior to p�tmit i�3u�hce. �urther�r�ote,if PaS�p C�unty Watee�'Sewer 4mpact
<br /> fpes�r�due.they mus#be pasd prio�CO permit issu�nCe in accard�nce with a�lic,�ab�e Pa3co County ordinances.
<br /> CON5TRt1C'tlOnl I.IEN t,AW(Chapt�r 7�3,F1oRda Statutes,a�amcnded)! 1f valuation af work is 52,50fl.00 or mare,i
<br /> �eri+�y that t, the �ppCcant. ttave ts�Qn pra�ded wi{h � copy of th� '�Ios�tia Constrecct�ah Ls�n taw--Fiomeowner's
<br /> �'rotection 3uide"prep3retl�y i�E Ftortda�Jep�rtment of AgricuitUre��7d Cor�sumer Aff�its. ifi the�ppiicarsf�s sameone �',
<br /> �ther#han thE"Owner",t c,�nify that!have obtaiiiatl a c;�py of the��bove desc�ined documeni�nd prom9se in good faith to
<br /> tlQliv2r it ro the"awner'prior to comm�ncement. ;
<br /> �ONTF2ACi'OR�SlQWl+f�}�*S AFFiDAVlT: t cest?fy that aiI the informatian in this appiica6iqn i$accurate and that at!work
<br /> witl ba don�iit campli�nce with all appifcable laws regc�lating construct(qn,zonirrg and I�ntl tlevelopment, Appiic8lion is
<br /> het�6y made Co Ont2in a pernait to tlo vr4tk and inst3��8k�On 2v ir.diC2t8tl.� ! CeRify (I18E Ao w4r1c Ot;f1St�tEl�Gs}ri kids
<br /> ao��trttenc�d prior to Es�an�af a p�rmit�a� tt�at ai�ovcr�rrFii�e qerfotm�d to meet�tandards af�li laws tegutatiag
<br /> ca�siruCtion, Caunry and Lity codes, zoning regulatfOns, and land dev�lop�nem r�gulaGans in the iurisdi�tion. I aiso
<br /> cedi�y that I undersland that the regutat�Qrts bt ather gavarnme�nt agenci�s may apply to!he;n��nded watK,and that it is
<br /> �1y��sponsibii3ty to identify vrhat ac�ions i must t�ke ta�e in compli�nce. �uc6�agenG��s include but ate not timlteG to:
<br /> � U�partment of L•'.rtvirt�nmantai f'roteCtion-Gyp�2ss Bayhe�d5,Wettand Areas�na Envir4nmencally Sertsitive
<br /> l,ands.WaternNast�wat�r Trealment.
<br /> Sotr�rwest Etcrtd� Water (�anagem�n# E�ist��t Vi,'e11s. CYpr�ss Bayhe�d5. W+,tfi�nd 1k�2a�. Aitering
<br /> Wat�rCOufscs.
<br /> - Army Cnrps of Enginesrs��a�walls,f]ocks,Nsvig�ble Waterwyysi
<br /> • �6p3ttnl�ttF pf H�aiih $r �'B3'S2i�iiitdliae Se:vices�Environsnentat�-Eeakh Unst-We31s. Wastewa±as Treafinent.
<br /> Sepi'sC TankS. i
<br /> - US Envlronmentat�rotectipn Agency-Asbe�tas a���Qment,
<br /> - 6aeler�!Aviatioii AuthQsiEyFtun�v3ys.
<br /> �un�i�rsian�tt�at#t,�ic�i�ow�rsg rest�ctions appCy to tha use ot i�t: ' ,
<br /> - u$e of fiU is nat aeldwed in Fload Zat�e"V"u�►ess expressly p�rmitted.
<br /> lf the fil! materiai is to be used in Ftood Zone A", it i5 uad�Cstood tna�a dra'sn�ge plan address,n� a
<br /> .campens�tt�g voiumeg w�fi�e svbmitted at tir�e af pprmrtti�z�ov�i:h is p�par�ct by a��o�ess:ona�enginear
<br /> iicens�A by the Sc�te of Flarida.
<br /> - If tl�e fill m8teriaf cS to k� vsed in FI4otl Lone`A"ir GOnrtpCtion with 8 pefrtlRtgd bufidin¢ uSirtg stem wall
<br /> C4r�Sifucti4ra.S cen':#y tE}at fili witC�u3�tl�ttly to fit!the�re�Wititits�the�T�sn v#�II.
<br /> - H F+it matsnai is io be us�d �n any area. � cert�fy t�a; use of gdch fili witl not atlVc3rsely sffect �djaten#
<br /> pfpperties. �f use 01 fil!is fqund t0 aCvQrs2Ey affect adjaCent pro�eRies,t�e owner rnay De ci#ed for vio�ating
<br /> the canrlitivns vf the t�u�tdin�germ#t issueu untl�r t��e a�tschv�parmit�pplication,foC Iots!£ss thsn an�{�}
<br /> acre wnir,�i ar��tavated�y fli�,2n errg�neeted dtaitrage pt�n i�rsquired.
<br /> If I am tY��A�pENT EOR TH�pWNEFt,I pfplPti3$Ef1 QOOd 12i�}1 t0 In£9RTI th8 OtINf1�r OP Lft@(1�rtnirti(�(��pntlt�ip115 S@I fORY2 iA
<br /> th�s atfcfavit prios to�tsmmenc�g canstruatro�. 1 una�rskand th��a s�para#e,permit may b�required for al8ctricas wa�k,
<br /> pEumbing,sigtss,w�1t�,paals.air cotCiltioaing.gas. ot a4E�er i�staAatiost8 n��specifc3�3y i►tClUCBd ist{�e appiicB:�Gn A
<br /> permit issued�hatl b�3 Construed ta be a Gcer,se ta praceea vnW tit�wor�and�qt as autPrarity co vio�ate, r�ncel,a�ter.or
<br /> set aside any provisians ai tt�e leahnicyl cncles,nor shafi issu�nc2 ot a perm�tipravent mc I3uii4ing t�ff,cisl h�m ttte�ea��
<br /> tequirin��Canecti�it fitf etrors�n A!2�t�.COttstnlGKon or vi0I8t:4ct�caf any CodES. Fvety petrnit isSueC S�tal{l�cbme ittv23stl
<br /> untess Ute wqrk autharited by such pOffnit is cnf�'tmenced within 5ix months oi permit issu7nce,or{t work autnoti2ed by
<br /> the pemiii�s Suspe�ttled or abando��d fvt a pericrd of 5ix(6)Tt�OrYths aft�r itt0 Eime ihe w0�k is commenCed, An extQ�13i0n
<br /> �+3y b�seqUeSteQ,in wciring.$or�t tt�s Buftdirtg Ufticsaf for�4�;tiCt3 n4t to exg�t�'sneiy{90}cfayS as�d WiH dernonSir�te
<br /> jus�fabie C2us�#o�trio extens9on tf w4rk cea;+�s for�incty(s4)Gnnse�culiv�dFys,trie Jois is cor�siqered abandaned.
<br /> WAl2NlNG Yp 4Wt+#ER; YOUR FAlt,UE2E TU E2EGQR}?A NQTECE C?F Gt?MM�NCEMEF�MAY RE�tlLT t1d Ypi�R
<br /> P,4Y�t�G 1W�G��OR 1MPRbvsmEN"i'S 7�i�rou�af�c�FEarr. c�YnU�r��j�ntA�"a Os�a{N FlNawclNG�cbr�sui.'f
<br /> Wi?Fi YOU�k LENbEFt 4R AN t70i2NEY BEFOR�{2��d}2pING YOUit Tf� CE OF C MME CEMENF.
<br /> FLORtOr,,lUfiA7(F•S ��r
<br /> 4WN6R tYR AG$NT ��Y-� � C6NTRACI'4R
<br /> Sub•",G"rb8@ sr�Y„¢ijt V.6 y�y�f;t9!'11'hl• $4p5Ud}EO��1d b o for�f`�e'R�9G t bEf4rr ma t7'fi5
<br /> Wrio j:c,e:-,sc,n tyarnv�:o:r.��es,ar�nawarCv�ucr,ci ' W r,;t�ra:�sctaY,*���+ �.�+�,r,�
<br /> l�_ —��`,_t,,�J�C ar h35ftt8v
<br /> �}j�10a+� aF KxR�tduSttttrt i R,�, „ . 8.�de-,ifrGBlron. .
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<br /> � , .._..Nc�ury Pvb�tC d� ,�„__„Nu�y Pub�ic •
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<br /> N�mr.r,t NOtB�y� ,p�' c �.r,ama me o,Noiary typq�:printpa pr S;s; �' � '
<br /> � P►ot�ty Ptd�fa S!�at�lorida ��� �totec�r F+uf#c cr. . ;��,esa
<br /> . S�h�iC�ari , � � ���� ���_,�:+'.i+"+
<br /> '�j* � �Y�FF2� "�. hRyCOrt++niss,.;r.rf :�'�3B
<br /> Ol ��/�A1� � 07� �«':nC��,�l?(ty:
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<br /> b041,E00'd 88sE# 1S�Q3iS3N� OlZ£��6£G8 0��1.4 9k4Zf9��&0
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