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<br /> �i rra����s�etcno�s: n,e�ur�eest�s�t th�a penr,it ma�bE sati�eat ta�.�a�iqloM�°
<br /> I; ,�hic�may.he more restr�tive t1�n courny re�ula�s. rna tu�de�sdgr�es��es�lp�y.iar ao�n�iler�oe urilri say
<br /> �d�r�ons. !
<br /> UNt.iC�COli7RACTQRS ALd� CONFidACF�R R�5�OU8lBiL91'!ffi: K tb a�M�a�es hss I�ired a COc�lCtor a
<br /> coc�tractors la tmddta'ke uraic.theY►naY!s�reqt�ad 4o be�c�ssed fi A�v�h&�E�td br.El P�D�etiD�s. K�}9B �
<br /> conlr�tcr is nof�a3 required by tasro, ts�h the�r e�d�c�ad�istiy he e�far a te�lsQere�lfor tiioir�S�n '
<br /> �s�,e tsw. �f ine awr�r or E�ste�c�trecsor��ms m vi�e N�g�•�ttey►App�►:loF.tl�e I
<br /> I� �rte�ed wvrk,t�eY.are sdv�ed to cor�tact fhe P�sco County�te�p�an Oi�stoea--Lfcmt�tks�.$�ilOn rd 7Z1-64�=-
<br /> eoos. Fu,��, n m� �n�s r�a a �«���s, ne_� ea�a to��aa�s�_at�n I
<br /> I vcrtlar�a ot tt�e"cor�or elaci�of thls appifc�i«,tnr whd�l6�r v�t��spoes!lbie. If ycu..s��e c�a�p,ea the I
<br /> c�or�r�cxar,tt�at r�y be an irialcaUor►a►ac ne ia noc�►rrt�nsed a�d�a��Od to penr�g prf�h Ras�o .I
<br /> Cotn►tY• I
<br /> 7'RANSPORTATiON IMPACT1iJ71L1T1�S MlPACT.AMD��MERif F� The t�t�ed tnde�afar�d6
<br /> tt�at Trarsspo�r�lmpact Fesa and itBc�otese Recov�ry Fee�m�y appir�ttle,cot�ort of new_bt�egs,Ch�r+pE Of
<br /> t�ae En e�ds�g bW�gs.a e�ar�ia�af exis�n�buNd!r+��as s��Pa3oo C,ous�lyr�eFfoe�r�:�07 ard ,
<br /> 86�07.as am�t�d�d. The�also trr�'st�rtdsrfh�t aud�16es.�.mey bc dam,v�be�ed et we tY�a�C� �
<br /> Pe�9. tt k f+u9her�sEood�tai T�r�partaUon Irt�yact Fees aRd Re�otsae.R�ywyr f-aes mt�t tie p�id,plbr Eo
<br /> rec�vinp a ber�at oxupsr+q�'or t�al pavaer�feffie. t�the�.does+�oot�ro�ie a:ear11�.ct_�a�ati�r or
<br /> fmal pcve�r r�e.ti►e 4ees must be Pald�r�o Pem►��. ��fhefrEfom:�f P�Oo�s�lY WaleG�ew�r k�t
<br /> �a ane due.theY rra�st be pae�p�iot to p�sr�it issuae►c�in 8�rda�with epplicaDie Paico Co�l+j ordFlorx;as.
<br /> CONSI'RUC'RQf�!UEM LAW(CM�t 713.�Ibrd�a�.bz anlc�dj: tf v�ks�Dn c!w�Oth is�2.60D 00�mo�.t �
<br /> cer�ty ft�at 1, the e�pqcar�t, ha+�e bean provlded wiitt a oopq a!Ehia "FlOdds CQ� Uen �
<br /> Proi�n cw�e•ar�ar�d by me Fla�i�DepaM�rd oe Ag�x�re�x!Cor�umer ati�. If f!�applcant I�sceneore �
<br /> other tlr�n the'awne�'.�c�ttty tl�at!heve o6t�its�d a copy of tt�e e3�cve dasa�d d�r�ar�t�p['a�nYe in�Ood t�to '
<br /> c�iw�r if to�e'oNrt�:f prior to connr�a�t.
<br /> 'S AFffDA1RT: i oerSfy tltet atl tlte irrfo�n_fn�8s app�tlOtf b eDClsals 9t1d tlt�t afl.W�xk
<br /> wtp be done in ca�tptiance v�h aN appticsble lawa t�gttl8t�g consU�sdiorr.zadt�g snd land�. �4ppic�otl Es ,
<br /> hsr�by made to abta#n a petmit to ao wark end insls�atian 2a irtdirated. 1 c�ttMy tt�at f�o woff�_�at�_h�5
<br /> carrt�r�d prior to Ess�of a perrtdt and fhat efl work w�b3�orraod��tK�ef s�dsl+dB d A9 liws'e�gt�al�
<br /> �fon, Caur�Y and CEEy codes.a�in8 re.gutatior�s, end I�d d�elope�+ent ri0ptd�S En.lt�E Jurlee6odoa:";1 tlisv
<br /> c�4ify+that 1 uncfar�rtd tt�at tt�reg�atbns of otlaar 9ov�rr�d ag�s nsay►applgr�g�e @dtieded wotl�.:i�nd Bf�!id�
<br /> mY�P�+��S►to tder�ffy what ac�fo�s t must ffiio�to be In�t�at�. �8�ar�c3es lledt�de htt ae�e Nt�Q�Ea:-..
<br /> - Departrneert d Emritar�srsertal Profficfion-Cyp�ss Ba�s.llVelt2�tid Ase�s 2�d�6aiie+0�1ir�1�
<br /> Lsnds�Ul��Ttaets�nt �
<br /> - sou�»,�st Ftoroda water Mana�►t o�ta�w�. Cyp� Baytt�sds. W�d A�as. Ailetit�g ;
<br /> 1N��rCatases.
<br /> - ArtRY Csirps o#Engin�as-.S�awalls,E�oc3cs,Ntau��a4orv�s. _ �
<br /> - D�en4 of Heaith � Ret�NEtattt�e H��h t1r�,1�Te�eetrtiee�t, �
<br /> Se�ic Terdcs.
<br /> - l!S Ernirartrnsnta!Pr�rti Agency-Aatsestos 2b�rr�t. �
<br /> - Fed�et Avi�lun Authaiiy-Rurndrays.
<br /> 1 tmders�nd Utst V�e'fo:towFng cesL'hstlans 8pply to the use of ti!!:
<br /> - iJse o!�1 ia not eJ'awed fn Flood Zone'V'ursicss ex�s9y�. '
<br /> - tf tlss� fiH n€�Eerial is to ba t� in Ftoad Za�o A, it Ds ta�desatood tlt� e drek�e0e f,f'k� edd�g�a, �
<br /> "cart�a�ng trdu�rie'wiU be st�nitted ffi tlrrte af pe�mfd�whE�is peep�d 6y a�tl e[qiJ�ets' ,
<br /> ticer�ej�d/b_y,tl�t^e_Saf�e{o�f{F.1�or.E,d,�aJ. y��� y� ����p����y� - : �p
<br /> - ����.,�11.f�/{,I�lK..�li61 IS N Yoy�4���Rry��{��,'�,��,�{ LWRi��yAy Y�mY��oS�tli.l.'.i}Yy�.N�w��WW��y�.����_�.�_wP
<br /> VlA 4lY{`i�iJYl�����.��171�WAI LG!�i�t0 KW�wV�+.WfLw'��0���. • �
<br /> - If fiu rr�aterla� is co be e�d tn �}r area, � c�i�fy 1F� �e.ar s�uh t�l+a�! rrot ad�iee�ely.a�eGt a�oe�t
<br /> pm�Nes. If use��!s€�urtd to edverseiy atied 2d}e�r►3 PmP�ed.�Ct+iia�er�trlaY b0{�for I�fo�,
<br /> the c�onattior�s of the b�r�g�rrrttf iesued tr�r����a'►.�b!6 bi6�I�f►di�'��) �
<br /> 8�xe�ar�el��raEad bY f�L en�dra��i 1�r�a�od• - -
<br /> ' tf I 8t»�Se AC+�f11'FOR itiP'OY�tER,!ptott�4ss In good fz[#t�to irefnnn fPae oarr��€.�i perttt�C�l�lofld.seit�Cr!!�bt i
<br /> ttds aftkfavit�xior to canvrtetx�ng cat5tru�lon. I�d2rst8r�fhat 8 s�tsda p�n��►b�f�OQ4�ir�d taf e9eC�d=tt�[i4 "
<br /> �t+mbEnD.si�,va�ta� poo�. efr corsd�orein,q, 9as� or ottter Is�iiatiorss not s�kx�ud6d�t,#ie G{tptC�efs A
<br /> p�+�ed sfwx t�e�ro a�a r�e to p�c�ea�stx�w�ic erid noe e�s aa�iy m vio�,eeo�al;aM�r:.t�r I
<br /> aet a8ide anY�ovisforia oi the ted�tc�!e�des.r�r sh�issuartoa d�p�nit(Re�esd��-i�l�i i¢o1i�►#+e�+a�
<br /> �ufrincJ a cort�sr�lon of errora in pl�s,�ort or vtota�aros ot Fsty cadDs. Eve�y P�bsu�d:atiEb���,i�e�i i
<br /> ur�c�s tl�e wark euthorfzed by such p�rNt is camrr�abed w�n siz�,oF pe�c�t�oe.dr tf te��b91.. '
<br /> the pertrut ia s�peradod w abandors�d for a peciod of six{6�mor�tles Sf�t�he 1irti�tl+e w�ork�a�xn9tdfaed: ib e�eri�iC� '
<br /> may be ret�t�sted.in wri�ting,fsom Ihs 8tn'lditg�ffte9al f�t a pesfod not ta eoceeed eMaf�►�days�t vd9�Oile�ta�s �
<br /> �ifleb4e cattse qos ttse ext�nsia�. H v�orlc�for nuse4y(90)oor�ci�ts,tfs�jo�is cosis�r.�d a4endor�eeF: ;
<br /> WA�TO�Ai!l�Z: YOiBA FAILUR�'TO RECt3RD A t�T�B?F , Y!►Y�LT 8!Y�1��3
<br /> PA1PIt�i6'fNiICE F05t TA Ytidl�PR0��4Y. !F Y�t91�ITE�IQ 3C1�BYT�J f�l�fEi;E�!&�tl1.7 ,
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<br /> S�soc�ae�awam to(or al6imed)befan me tlds f/ smom � /`//�jl%I 1/1///,/ '
<br /> l,l ,e e,,�:�s,�a
<br /> Wh0 WsrO paso�y lu�o�wn tn ma ot h��o�e�d i�e p�f� b��►►�� I
<br /> aa ider�atlon. a �s� ' �
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<br /> �a�Y��ti4 DEBRAELAINERUFFELL
<br /> ;i�� �';__Commission#GG 045343
<br /> r;�q;Expires November7,2020
<br /> ,� �•?,•,�r;°.•' Bond�d ituit Troy Fain tnsutance 800�38�7019
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