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NO'�CE�F DEE�I�ES`TRICI'OONS: The undersignect.un�er�tands��.th�t,Ohl�,p�e;mif;rpay,be.subject to°d��d".res�rictlons°
<br /> which may.,be=more`urest�(ctive.�th�f�r Gout�ty'+regul�tions. '°The°undersigried�'a�sumes��esponsibflity`for'coriiipli�nce w+9th any
<br /> applicab0e d�ed;re�fri�tions. .. �- - • -
<br /> UNL9�EN�ED-;C,QNT�C�OI&S.AND _CON`��►CTOR RE�POIVSI�ILI'r1E�: --1f�tti� �own�r�has--htred°'� a�ntractor or
<br /> co�tractors to und��take work, they nnay_b�.:eequlred�to��b�,;�Icens�d On..accord�nce.wlth state.�nd:Bocal.r�gulallon�. lf�the
<br /> conQractoe.f�, nof;:llcens�d-as�r�quleed`tiy l�w; tioth the ou�er and.��nt�acto��may be��clted-for-a�misdemeanor violation
<br /> und�r,�t�te;law. If the..owner or Intended;;cor�tr.a�tor:are�;unc�rtain a� to what Ilcen�ing;�equlremer�ts may=:apply��r•the
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<br /> inter�ded work, th�y are advis�d 4o contace`th'e';�a�co.County�u0ldie�g 1n�pecQion Dlvisio�-�Llcer�in�;S�ction at 72Z-84a-
<br /> 8009. fFurthermor�, If`th�-oameE'has'::�itied'a'contrector or contrector�. he ls advi��d�to heve�the contr�ctor(s); sign
<br /> porkfons of the "aon�r�ctor Block° of thl�,�ppOtc�t9on for.wrhich th�y vvill"be�espo�sible. _If.you;..�s...the oHirier'slgn as the
<br /> contrac�or, 4hat�ay be�an indicatiori fha#`he ts:'not�:properly iic�ns�d and�l�°noC entitled,to p�rmitttng prlvlleges Irr Pasco
<br /> Cou�ty. �
<br /> Y�PISPORTATIAN:-IAAPACTIIlTILI�I�S<I�II�AC'I�ANb-t�ESOFIRCE RECAIIER`Y•FEES:The undersigned�und�rstands
<br /> that Tr�nsport�tfon.Impact Fee�s:and.Recourse Recove.ry.Fees may;;:apply�,#o:tF�e c,onstruction„of new►_bupdings,_chan�e�of
<br /> use ie� e�i"st6ng.tiulidings;�x:oP�.ezp�nsibnE;off�xl.sti�e;g',�u11%ti�8s,��s'specifled:in Pasc� County�Ordin�nc� number�9-07 and
<br /> 90-07, as�mend�d.,:,�he undecaigrred also;u�d�rsta�ds,'th�t:°su�h fe�s;fasttnay�.be�:.d.ue;,wtll�be id�ntlf�ed a4 the=ti�e�.of�
<br /> permitting. It ls furtl%e� un�eestood that'Trarispo�tlon Impact Fee� �nd`�F��sour�e' Reco�er�i:�F�es._muat be p�id prlor to
<br /> ' recefving a "cerfi�cate.-of�ocxup�nc�o"°or flnal•.powec-rel��se. :I�:th�pro�e�t,;does:not involv��:�:certiflc�te of accupanay. or
<br /> final powcerc�le�s�;.,the::fee�-;,must be pald•pPlor 4o p�rr�it lssu�nc�. �Ft��thermore;;If Pascv,>County 1Nater/�ew�r.�imp�ct
<br /> ! fees are�due,they musi.be�.peid�pi�or to permlt�lss4ance�:in�cc�rdance witii:appl0cabfe:Pasco'Counfy ordinances.
<br /> � � COAl�'TRUCTI�N`L"IEN`L�1►1fN'(�t��pt�r 773��9or�da Statutes��s arnend�d); (f vaiu�tion of work Is$2,500.00;or rv�ore; I
<br /> � certi�t that i, .�he,•�pplicant,.�hade��b.e�n�,,provl.ded-utrith a=copy�,of �the- "Fl�rida•�Cons�nuction� L6en`L�vu�--Homeovuner's
<br /> Protection GuideW prepar�d by 4he Florlda Depa�tr��r�f of Agrtc.ullur� and Consum�arAffair�. If�th� applicant�is svtn�o�e
<br /> ' othee ihan th�°owner";I certbfy;,that.l�have.obt�inea>a•�copy,�f.th�:abo�re.des,criped�tiocu�ent�_and,:p_r.,o.r�ise��in,good�faith�to
<br /> �
<br /> --- deliver ft�to�Qhe,."-owner°.prior::to*cvrnme�cemer�t: : "
<br /> . COPi'TFtACTOR'�/OYVNEtB'�A�FIDAVIT: I.ce�ify-;tkie�Q.ali�;ttie�li�f�rm�tto��:;l�i�.thi�appl0ca41on�is accurate�nd that all work
<br /> �rill�be don� in compltance �vith all.appl(c�tile'I�wrs regulating constructlon, �oniwg-and��land=developm�nt. Applicatlon ts
<br />' hereby rei�de;te obtatn .� permit.to do,,�ark,,.�nd, li�stall�tion as indiceted::�- I certify �tPiat no work.��:or Instell�tton has
<br /> commenced p�lor�to�lssuance of=� perrr�dt'�nd that:all woPk�will be p�rfoPnn�d�to me�t`.standard� of-all laws r�gulaking-
<br /> cons4ruction, County and City cades, zoning reguta4lQns,,and land dev�lopm�t�t regul�tlons�tn 4he�jurisdi�tion. I al'so
<br /> c�rtify �h�t I �a�derst�nd that th�eegulatlons of oth�r governm�nk ag�ncies may�apply:to the,int�nded work, and that it is
<br /> my Pesponsibi0ity to identity�wrhat.act(ons I must take:to b��in..corr�pllanc�:.,�;uch ag�r�clea lnciude but��re.not Ilrnited 40:
<br /> - D�partmerot of E�lvironmental�Protectiori=Cypees�.�Bayhead�, Wetland:R�reas ��d Environmenfaliy �ensitive
<br /> Landa,WatedlNastew►�ter TreatmenQ.
<br /> - Southvm�st Florida IlVater (Vlanagemer�t :I�is4rict-Well�;°�Cypress.`���yheads, We�land Ar��s, Altering
<br /> Wateecourses. � - : ,
<br /> - Army Corps of Engin�ers��awall�, Docks, fdavigatite VVat�rways.
<br /> - DepaeQment of ai�alth� �-Ret�abllBtativ_.e._S�avlcesLErnrironm�nt�l�--F�eelt7� Uhit:l�fell.s, Waste.wat�r�TPea,4roient,
<br /> SepNc"Tanks. � � � _ .
<br /> - �i�.�m91i�PO�i7i�l"1$e'i�'�P�i@f:u�iPi e a�Saofiji-r�v'auiroi��s`a�i°i?aao�iuoqiQ:.
<br /> � Fede�l Avlativn.Aulhority:Runways. - .
<br /> I und�rst�nd that th�foliowing;cestricfion�apply�to the t�se of flil:
<br /> - lJse o9 flll 9s not allowed.in Fiood.�one"V"unlegs expr�ssly_peemitted.: .. ;
<br /> - If�the'.��11-'�naterlal ,l� Qo.be u�ed::�ln.�Flood Zon�. "A�, Pt is under�tood-th�� � draln�ge plan �ddre�stng a
<br /> •� "compensating.volum�" wiil.be submitted at time of p�Pmittlmg virtiich ts prep�red by a professioraal eng(neer
<br /> licensed by#he�:�tate��of�Florida: ' ' . _ ..
<br /> - If th� flll material�:ts.�to be�used in Flood-Zon�,'A" in�conneetlon��-with.�a`�p�rmitted building using stem w�all
<br /> � constPuction� I ce�tify_th�t flll:wp!{b.�used only.to.fllY th�are�.withln�th��stemvw�li.
<br /> - � Ig flll m�tecial "is to be used-�ln any are�,'i cer�lfy tfiat .us�. of eucEi'f191 �wiill,.r�ot �dv�rsely a�f�ct �dJac�nt
<br /> prope�les. IP use--of fill Is.f�und::to adversely_.�ffect`�adJa�er�t��properties,.tha owner�ay b�clted for viol�ting
<br /> the condNions of th�"�tiufid(ng�:;p�ri�lg issu�d�und�r the at��ch�d�ermit;�applEc�tlon, fqP:lots I�ss tharr:one 41)
<br /> .. �ce�wrhich�re�;elev�teef�tiy:iJIY,.�n engineered drain�ge pla�v ls requlred. �. ' - •
<br /> If i am the�AGf�WY.F.AR_TH�A1RlIdER;'�I;promis�tn gqod f�ith to�inform the=owr�er;of�th�:per,mitting condittons s�t for@h in
<br /> this aHidavtt;`prior to cori�rri�ncing con'struction: 1"understan�:.that a-s�p�rate��permlt re�ay be requlred for efectrlcal work,
<br /> . �..,
<br /> plumbtng� signs;;v�ells�.�pools;,�lr�,conditloning,;gas�.'or.oth��.lnstal�a�lons not�.spec�fileally�inciuded-�insthe �pplfc�tlon. �A
<br /> peemiQ issued shalfb��.constnaed�to:be�a'Itcense�-to.proc�ed wlth th��v'vork and noty�aswautho�ity to:.viol�te;�cancei, alter, or
<br /> set aslde�any`provlsions of'the:tectinlc�l'cod��;�nor shall Issu�nce�of a.permit.pcev�nt the:Build9�ig.-O#�ici�l from thereafter
<br /> Pequlrin.g�.corc�cQion�.Qf�.�ROP��in�,plans:;::con�tructlon oe viol��ior�s�of any"codes:_.�Ev�ry=piermft�l.ssu�d�shall become Bnvalid
<br /> I unles�,the wo�k�utho�tz�dwby such permit:�s.cm�nm�nced•within s{x,months;of;permit �eQ��r�ce, or_.f6�rk authori��d by
<br /> the p�rmff..is susp�nded:or.abandoned,for.s�_:p�r(od;of>st�_fB)montfis',=:afte�the:tfrn�th���re�'k is comm�n�ed.- o-4n extension
<br /> nnay�b�..requ�_sted;_Ir����writing;;;fror�e''the�Bu9idingaOffiAci�l°for� p��tod.:�ot ta.ex�ed=�tnety��(90)�day�-�nd�vuill`demonstrate :
<br /> �ustifia�le cause f�a:the extensi�n�. If work,ceaa��:for nineqi(90)cons�cutiv��d�y�,..th�)�b�is�consld�red a4���io"ned.
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<br /> IN�RNING'TO`Q9RIfVEIt:'�"OUR:;FA�ILIJRE'=�T�:;.RECzO�D.;;e4>:MDTIG�.O��C.OMIVIEN�E�AENT�MAY=BtESIIL.T IN�1fOUR
<br /> PAY9NG TWIC�::FORfIlNPRO`iO�AEIV�3;sT�?YOUR F!����R-T1f 1�:5(0.�1�Of�'�EWD^�TOrb:��T�IN�FIRriA��iNG;,.C.ON�ULT
<br /> ."dl9aT � ;�e�e�e`. .� .�r�:�`��e,`:' 4T�nB r .:t� . ,�g i � 2:� � ��; � ' : .;� ;, ;n�av ' Ae .�w �,� - - �
<br /> FLOFtiDA JURA'��(F:$.t,1�9:7;03}< , '. ` . ' .
<br /> • •.OWNER'ORAt3EN7...- ,�i.�.. �--�..... .--�.. CON7`RAGTOR=:• ,�:.� .,... : '
<br /> � Subsci�bed and�m ta(oP a�irm� �ore me.thls - SubBcrtbed and'�watct=b.oc:��irmed):before me thi�
<br /> -� - ,..�.;:by......:. ... ... ... _.:.,.�
<br /> Wlio-Is/are'pe nel me o: ev,�.�ro�u Who:ts/are R�rsonally�cnovue�rto;me.or:khesfhevesp�oduced- •
<br /> ; �-.:. . otar� �f��ws_: . .- ..
<br /> • ���1 eX. " ,� Notary Public State of Florida
<br /> , 4 �� _= a My Ganmissioo FF 185059 - ;4 � Gloria Rifey -
<br /> � �a�, ExpireB 11/01I2018 @ My Commission FF 165059
<br /> .�(/� ' o �Ilc � ex�res�uo�no�s PJotary bllc
<br /> � - ��y
<br /> Comml lon No: �� l���J � � � . Y Com�I�slon�No. .
<br /> �/�3�-j�- � �d�i� . _. � - ;(J/6�i`%� �i��i': '
<br /> Mame oP�NoFaPy typed,:Printed o stamped Name oP Idolary typ�d,Printed or atam ed
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