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<br /> f AiCYtCE OF D�ED R�7REC7'iO1tS: lt�e�rdersigr�ed ur�tst���Is{terp�it rrtey be 6�e�60`d�t8'aD�a1�
<br /> ,/� vut�ch maY-6e more restrtdive Usan Courtly�egulsti�s. The tsid.r�*r..f��sstCdlOa �Dr�npiF�etoD wi�ac�f
<br /> aPplicable de��ri�.
<br /> 11Ptt.K:ENSED CONT�ACTQR� ANiD C�ACTOR R���O!l91�L�7f�: [f th� a�r M�s Fifrod a conlr�_ar
<br /> cartr'actora to un�teke vaortc.thel+�!1 be requi�ed to be Ei�tn�vai�t s�te�d betl r�oRa. �!!ie �
<br /> COfttrBdOf fs nOf�89 t�equiiBd by(8W, bottt ftse aM�8C1d c�1�0T Atiy hB_C�d f0[i le�idEtl�}QOf,Vf0�1
<br /> �aider s�►aw. {f ade awn�or Er�tor+ded�f�sdor are�,s�m afisc No�e��ev�+enlenb��+feyi+Ipply+��1e
<br /> Kne�,aea wo�+�,tr�er are�to��►e P�c�ca�r�y+�g:r�p�o�►t�fuiaioe�--ttce+�etao_see�n�it?�7-�tr-
<br /> s408. Fura�m�or�o. fi rrie o�aner nas r� a co�fracUor a�� ne b ed,�aea�o t�eue�h.ea+�(sa�Q[►
<br /> portlar�s ai the"�a�tor Btoc�c'of thts applis�an for��w�3�msp�ibla. �y�u:�9�owtle►�n ae thB
<br /> oosbrad�,Us�t may be an lnd�caUon tltat he�r�ot pr�ly+i't�a�sed 2�d is no?er�d t�pptr�irf�priWeges h Pa600 •
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<br /> TRA�TMTI�t ENlPACTNTlU'i��AC1'AFiD�18�CO1ILRY F�: Tha tr�terti�ned u�delatencf�
<br /> tl�at Tras�spor�ior�lmpacx Fees and R�snse Racav�r}►�s rt�!�iy to tl�e�t oF r�w.bu�;cgferqa CP
<br /> we 6r�existtng buildf�ngs,�e�ar�sion of axistG►g 6uftdlr�s�-€s sp�iri Pa�Cot�niy�tti�rtlbdr�8-0T erd
<br /> 90-07.�srrr�ded. The tmdmaigned aiso t�r�ds.lt�t se+�f�eeS.es rtts�r be dtso.taEt be Idmni�ed if rie�n1e,�
<br /> perrrtlttlrg. k is fiuth�tmdets�od it�i Tra�po�Irrtyat�Fees 8nd F2esoeP+ao.R�o�y fee��t be pid pilor b
<br /> reaeiving a't�rtlflc�te of o�r"or final paw�r na,teese. ff the piojecS doc�s not�nud�e e�of�oqspen�►a
<br /> tlnal power re.�a�e.�e t�es rtwat be R�P�'to perrrtit ls5ttence. F�ufllertsfote,!f P�ca Cour�r Walof�w6r ti�t
<br /> fees ere due.tlsa�►m�t be Paid Prmr M Pemtit i�nc:�►n ax�dar�ce�app�bie Paseo Co►+rhtt�dir�anqes.
<br /> COWS7'RtiCTtCN UEa1 LAW(Chspt�[7tS.Flor4�s�.t3 6rafBea�j: !f vahd�afl of w01�is�li00.C�Ct'eni�.t
<br /> cerfify that I� the appi�t, Nave been proVid�d wi�t � ou�t of the "FlOrid9 C.on�6ns�n 6Jsrt .
<br /> Pra2ec�ti C,ccide'p�pared by!he Florida Dep�hv��of�8rt�i COe�f1#feit8. tf tl1B�pp/E�K Is BAti�eOne �
<br /> olher tliyan{�the�o�w�r���y,�artl♦fy tl�at i have��y a t�py af tbe ebav�d��a�eed dGza��nd p[01stf0a ir1 g0�1 takh to
<br /> �/►� �{W�yY[fqY��yIC'�1���+��lQ,��^�, .14. ♦�j�{{�� ��j� {��{�p��y
<br /> VV���7lV�/i7GP6�S/V�rWM�. (���l WI ID���UG➢����Y�6 CSi.I�RiLi
<br /> �ad�b8 done tn c�ianoe v�th aH appiicffi�le laaos�s��,m�tg End le�td de+rt�rnerd..��
<br /> h�eby rnade to d�taM a psarrdt to do work arsd inst�ll�t�On � �. ! oe�►ltiat F�o i�icxic.�i�t irql�Elon t1ce3
<br /> cam�r�soed psi�x to isaw�r�ce of a pemdt artd that efl v�oek wd�be periamed bo maet�rs8�ds d 8q[e�s_tt�
<br /> �on.CouraY and GtilY c�da�.zortfn8 r�3a�s, a�d lss�d dovefopmont nrogtde�at�s I�-f#bD Ji�On. i Ytso
<br /> c�rtify dtat f ur�ttd�at ttie regttta�'ac�s oF aU�cu 9��!neY sPP�Y�D t�i ic�l3Wec{wdk.�nd�fHf it.�
<br /> mY r�pa��l#tY to�Mify what actions I ms�st�to b8 in o�noe. S�ch����a�+e Aot M�ihed�_
<br /> - Deparbs�ent d F.rniror�r�ental Proffie�ion-CYPrpss Bayts��1N�etlaM Are�8Rd Ei�tiro�8t+�ei(y=Seils�kR� �
<br /> I.�nd�, T�atrf�erni. -� -
<br /> - Sott4lsau�st Ftotida W34er Fdl�rtt D�h3c�-WEIlS. CYP� �. � �•��
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<br /> - At�gr Corps of F.n�rsee►�-S�+va9s�D�ics,Als�igable l�ys.
<br /> - De�arpr�erpt of F1e�Elh 8� R� Serv�sfErta�s� F{eetl� tl�.1l�61�r 7t0eht�oti,�
<br /> Septic TarMce.
<br /> - US Ernirorur�al Ptot�On�{q�cy-Asbestos ai�em�f.
<br /> - Fed�rel Avi88or1 AtRF�ari!)+-Ru►hn►�ys. .
<br /> 1 iusderatand the!Cto todCal�.ng c�oRs�ply to�a tu8�f�!: �
<br /> - llse�flfi is�k a�bu�ed in Flo�t!7_arse"V'ursl�Ss eoc�ssly�nrd�ed. -
<br /> - If tha 511 materfal Is to be �d in Flood.Zane A, �t� �od �r+t o are�e.p�rdd�ss�ng �
<br /> valu{r�e"vNa be submit�l at�of p�rr�r�fa pr�ered!ti e p�pa�eMtl e[�Oea'
<br /> lioer�d by the Stale ot FlotMa. � .
<br /> - rf 4he f@I mat�rfal is to be�sed a� Ftooa zasa"A•�can,�n�#fn a.�buiding tt6�aLeln:wi9.
<br /> c�nsbuction.!oefify that frH w�l be used onty to�1 t4ze am�v�)tin Voe ste�u�9.
<br /> - �f fl11 m�terlal i� to c�e us� Fn any are�+, � cettiiy mffi �s a wd, !�! �aY!.�at e�t s�;a��
<br /> propert3es• tf t�,se�fiN!s Lotsnd to 8d+rersety 84&���1!PfClP�+.�CeuraBr 1!'�aY�q t�le,d.lor�ifOfe� -
<br /> the�of thm b�&dir�g p�mbt Lsss�ec!�ltre�pemdt�pf�orb br IoE�1�5iB.th�t1��9)
<br /> �re+utt:c�are�earat�d tiY f�fl,an e�qir�et�d�Ptan Ba laqt�d. �
<br /> ' if 1 am the A{�EAf�FOR T�lE'�R.1�ar�se 8n good bI�to lrtF�f lS�e auue�of fb p�tg�xF+diliarfs set iQr��t: .
<br /> thl�aflfdavit prior to c�rtar�er�catg car�sfrtu�an. I u�fhat a s�arate Pemdi rrr�Y be roqttl�ad 1oi'e+lOt�iCel wOt'k,
<br /> p�umbEtg.si�s.weHa. poo�, air c�nd�iortfr+9.9�, or ott�r�ra�i s�t lr�ded in�e f�pk�Op: .A
<br /> pem�c�s�d sr�+��be cons�„ed to be a ria�€�pro�wid,tt�s,r�k�d e�ac as a�rEty eo.vlo�:e�ao�.aNer.�r
<br /> �t aslde arq+prov�l�s ot i�sa techrticaf codes,rwr ahatl�o�a pc�sr�t{�ev�eart�e Btt�'tQ.d3lfi�ei f��
<br /> �4uirtt�a�n oi errors�n�,�on or�af�sy cades• C-v�+Y�ls.suod atsi�becori�e it�d
<br /> �leas H�e vraric eu�riz�d by s�x�pemr3t�co�rrier�cd v�in sd�a m�aF.p�.�.,cr�a�ek�d b5►
<br /> the�t is s�spendad or ab�r�or�d for a perlod of sbc{6)�t�eStea'the 9ita�e!he+r�wk is�e�d::lb�.
<br /> may pe reQu�atod.in wrilirtg.irom tl'�e Bu'rlding Ofi�cfa!for a�tod reat tiD 6oc�0 N�9t�EOj dgs aeo�vi�l�i�es�
<br /> �le CBtme fOr ttoe ex�nsiCn. if woric c�3 gar nitee4y(80)oos�ve d�ys,ths joD is ca�isi�lene8�er�ot�:` .
<br /> WARNqK3 TO G1WPtElt: Y@iJR FAlLtJRE T�2 R��D A�E OF , , W1Y i�ll.T�l Yi�f�
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<br /> Corsrd�On No.
<br /> ;io`'"�•°`'4��. JACQUELINE HORRUITINER . '
<br /> I�nootr�orrytypcd,prrnteao�s�ed t�c+d :,�, ; �l�r+�MMISSION#FF1448t7 .
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<br /> `••.'„i'�o,�F,,o�'�O' EXP,IRES July 24,.2018 _
<br /> (ao7)3se•0153 FloridallotaryServlce.com
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