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<br /> ICTIONS. The ue�dersigned;under�tands;:th�t�thfs�.p�rm,it;rrtay:.be,subjer�:to;"deec!";restr`;lctloiis"v::�_..,,,_��;
<br /> N�'i'!CE�1i�DEED,RESTi3 , . , . :._ . -
<br /> whtchma tie=mpre�re�''s"tttctive��t#��i�r�Co�i�i 'i'��ilaf�oiis:'µThe:un"derslgned°'�issumes�responsiti!llty{foF"coifipllani:ewith"any
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<br /> appUcatile:'deedrestirictions. :�.; •�: . .. .,� � ..... _ : .. ,r.._� �,. ..�_>:._....-_..,; � -�-�" _��.
<br /> •e{}ar:�.�'.t.'l°p•:'iti ..��
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<br /> IUNLICENSED•�CONTRdC7'CMRS�:ANii CONTRACTOR�RE$PQNS181CiT1ES'��=�lf���ie=�owner' has"tiiired"a"ctiritir�c#or ar
<br /> undertake work�t_ ma �be.ir�quii�ed._ta,{tieal�ceneeil�irt;accordance.with;stafe�.anrl�iocal:r±�gutai�ons:��if�the�=.::_���-�����
<br /> cantractors to 1:�Y.... .Y . . ..,,,.,�.,.;.;:���,�,-:w..��r �
<br /> cantractar��is-nat�lEcensed�as��requlred,tiy{aw,:tioth'`ttie awner arid"coratrsctor��msy��tie�clteil�=.foir'�`�mi�demea�or v!olatlon
<br /> �nder state law. !f the ownec.or IMended1,con_trat�tor�er,'e..uncertaln �s'to,what ltcenaing�;requlre�nen#s;�may,�e�iPlYk��OFkthe°`;':'�:��: "��
<br /> lntended�avo'li,they a�e advised;to",'ciontact the P'a�co County Bullding Inapection:Dhti�lon-l:[censing Sectton at T27-847-
<br /> 8009. Furthemeore, if the ou+mer'fias"`lilred a�icon"tFactor"or contre�ctors, he 1� advlsec! to hav�r the con#ractor(s)��stgn,,�Sr,h„,,,,°
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<br /> portlons•of fhe:."rxvn#rector:Bfack".vf,;thtsbappflcation:fa.r_which,.they:witt.b.e�.r.esponslbie ,if you�-as��ti�e own�r�si�qn as the
<br /> �on#ractar; ttiet�majt be an Indicatiairi ttiat'tie�°fs��not:properly ll�iised��ntl°'is niif"ertBHe� to perrri�ktliig priu}feges fn Pasco r_ �w �
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<br /> CQUC1ty. _ ,.... .�..... „�.: .. „
<br /> TR�1[dSPORTATMON=lMPACTlUTILITIES}rMl�ll�T�ANb���tE�OIIRCE RECOYERY�FEES;�'Yhe�undersigried understands
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<br /> that T�nsportatian Impact Feesyend..Recourse.Recove.ry_,Fees„triay:apply��to�the`;constructl.on.o�.:new,buildings,;zchan�e��of����'�€='�'��`�
<br /> use in eiiisting buiidings,�or�.experi9l�n=of�ezie�i�i;g��iull`c#ings, as specffied.tn Pasc� CauMy Ct�dinance number 89-07 and;,
<br /> 90-07, as amended,t:,.,"Gi,i�underslgned elso;�u�iderstands� thait�such fees;�as�ma�ti�xdua;<�vult{���e.iderit�fed at the��tiiiie�of���� ��==����'
<br /> pem�itEing. !t Is itiiithet under�toatl'that T��sp�ortatlan lmpact'Fees an�a�Resource�Recov:ery�`Fees:,mu�t be pald prbr to
<br /> fecelving.a'cecUflcate��of accupai�cy"��or.,flna��.power:�elease:�..1��Ehs.pro�ect,;do�s�no��lnvolve�a~cert�icate of occupan%iy�ar`��4�';x�;�;,'
<br /> flnal pawer release;;the=:fees=mu�t,�tie"pattl�,prlor ta;permi# Is�uance. F��ther�tiore,�:i�Pasc�,,County`°1NaterlSewec�<l�npact :���, °=rt
<br /> fees are due;;theymust:be>pald p�lor.to.permit is.s,uance'In,accocd`a.nce`wit�:applloatile:Pasco'�Gauniy�o'dinances. •
<br /> CON�TRt1CTiON�CIEN`LAYV�Chepter T13�EfaN`da Statutes�aa amendedj: If valuallon of worlc 1s�2�SOQ.00�,or.�more,,�l�-�;. :-�:.x�N
<br /> cer#ify that• t; �#he :appticant;._haxe,,:been. provideil-��with°a�-c�py�.of�ther:"Flarida�Construction��Uan�::i:aw--i�lomeownet's
<br /> Protectlon Guide" prepared by,=ftiie Floi�da Deparkmer�t.of Agricuiture and Ca�nsum�r�ANairs. tf the appl{cant is.sameane;,;:..y.;•--�,
<br /> 3;.{�
<br /> other than th�"ovmer", !certlfjr,-th�t 1-li�ve:obtqln+a��a=e�opY:of:the3�bova:rles.crlbed��lo+cait�ent;and:pt�r�ils�:lri;good:faitt�.#a . ,., ,{<<
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<br /> deliver It"ta�.the�'oyvrie'"•:prio�°to�comm"e'ncem�nt:�', = � .' � � • _ _
<br /> �ANTRACTOR S/OVYNER S A�'FIDAVIT: I.cer,t�jr;=,th�at;all,�the�lnf�rm�ticmtl��this appUcatlon ts accurat�.�nd that�aA work � I
<br /> will'be done in compliance with a8.appltca�bte�iaws regulating c�nstruction, xoning and:�,la�d�deveiapm�nt. Applicatian fs
<br /> hereby made=to obtain�:_a.perrnit:;#o�:;doF w��k;��nd��ii�sfelfattan es indi�ated:�-�->:1� ceMNy Ntst no wark�Nor instatla#ion ti�s'
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<br /> comme�nced �p�tor to tssuance ot'�.a permlt'antl that�:all�work wlll be perfncmed�to meet�standanis-df�:aff law� reguta�ing-
<br /> construction, County and Clty codes, zoning regulatinns� and land d�velopr�ent r.egulatlons�in�ttie.jurlsdictfori:i=`�!�:ai'so=
<br /> certify that I �nde�s#�and that the regulations af ather�government agenctes may�apply.;,to..the:.Intended:wark� and that!t!s '
<br /> my responsibiiity to Identf�y•what.actlons 1�muet�takey;tot:be.�in�conlpllar�ce:t;Such,agenscles�Mnclude�but-are:not Ilmited to:�•
<br /> - Depa'tment of Er�vironmental��Piat�cf�on=GypreSs'B�a'yh`ead�� Vf/e�and.�lreae and Envtronmentaily Sensitive
<br /> Lands�WateHVllastewater Treatment. .. � y �
<br /> - Southwest Fbrxda UU�ter Managemei�t>=:C�ts#r1ct-.V'Uefls;=`''Gyipress,��Bay�eaii�r,- Vlleftand Aress� Attering -
<br /> Waterr.aurses. ,�- --; .� ..,s . , .
<br /> - Army Corps of Englneers�Seawalls;Docks�Mav'Igatile Waterways. � .
<br /> - Department; of�Health�;1�;�Ret�abilitattveW:;Servlces/Envinonmental�.F�ealtl��Unit-Welts;:�V1Fastevitater�Tre�tment, � �
<br /> Soptl'c Tarifiis:..� ._ . _ :. ,�. . . . � _ .
<br /> - US Envlronmenta!Protectlan Agency-Asbestos�bat�me,n� «
<br /> Fedeta!Avletlon:Autltat,ltyr,�fZunt�rajisF�, �.
<br /> I understand.that:the.�fcllowing:.reatrictlons apply to ttie use af flA:
<br /> - Use af fip Is�.not aliowed In:Flood72..o.ne"V"unless expressly permitted.
<br /> - if tFie:�fill' ma#e�iat��is��fo;'be used;�in::flaod Zane. aA"� it is underetood thaf�a dralnage plan addresstng a
<br /> °compensating vo{ume°wilf be submltted at#ime of>permitttng which is prepared by a professianal engineer ' �
<br /> ilcenss"d`by.#he,.�t�ite�of'flotlda: -� .:- _
<br /> - !f th� flll��•meteria!`�la°'to be�.used In Flood Zone 'A" tn�cannec#ior��w}th�sr�permitted bi�ildfng using stem waN ,
<br /> ' conatruction� I.certify;t�at:fUl.wlU:be;us�d oniy.to fll!the�rea�wlthln�the�stem wal1: � �
<br /> - If fill mate�lal-Is LL to be used in any area; I �cenifp,that .use. of;such flll will not adversely aftect adjacent.
<br /> propecties._.If.use:.of.f�tl,is faunct_ta:ad.v.ets�iy;.�fFect adjacent�;praipertles,.the awner may be clted for vlolati�g. �
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<br /> the�canclltlons��cif�ttteb�itding;perniifi�issued ut�det ttie�_af�acfied_�ecmit�:apptication,��for=lots�.less�than:ane (1)
<br /> aare�il�lati`aie elevated�tiy..�!!;��r;engineer�d dr�,inage ptan ts required. •
<br /> If!am the AGEINT FAR�TME:QIMNER.,l;.�iromise:ln.gaod,.f.altk�to i�fortr��ttie owner of�the pemiitting condi�ans=set forth in
<br /> this aTfidavtt`prior to comrriencln8 consh�uctlon. 1 underatand thet:a�seperate�•permlt may be requtred for electrfcal:work
<br /> :v.XWa� 1y7..a•. >.E 1 '
<br /> plumbfng, signs, welts�.poois,,-alr contditioning;,g�s;..;or:ot�er Insta(I�toris not�spec�leally included•tn.the��application. .A
<br /> permft Issue��hall be constr.ued ta'b'e,a�llcense�#a;�i�aceed with"'tFie:viiai'rk and:nat-as:�authority.-ta:vlotate;.-cancel, alter, or
<br /> set aside any�provlslons of tlie.tach�lir.al;cadeg;:nor shall fssu�nce�af a.permit.pcevent th�Buttdirig Ui�tdslfrom thereafter
<br /> requiring a con�ectlon��af;errors.ln-;plens;:aoristiuction.or.vlola�ans of-any cades�--�very-p�rmlt��lssued si't�ll�tiecome�invalid
<br /> uniess the work aiithoNzed by such permit:9s.commenced•w(thln s{�c..months ot permlt Issuence, or if uvQrk autttorlxed by
<br /> the permit fs suspended�or:abandonedyfor:a;period�;of�eix:{�)�montiis`;.afterfthe-tlme the�work�t�comfnen�ed.. An extenslon
<br /> may be requested,ln.writing,.bfiram,t1re;8uililing,�fficiafi4for a periad�not.fo exceeid'�ninaty�(90)�days a�id�willttdemonstrate
<br /> Juski�ab#e'c�use�or�the extensfar� if work ceases:for nlnety.{90)cons.ecutive�day.s..#he�ab�is cansidered aba�doneid.
<br /> IMAItNING TA AlA1N�R: YOUR;�.FAlUJRE;:TCI.,.R�E.CO�t�.�A,'�OTtG���F�:�G.QMMENCGME�T-:AIrAAY�-RESULT IN�Y�UR "
<br /> PAVIIVC TWICE:FOR�IMPROVEMEN�'��T�:YaUR>:P�L��ER�T�1F:�°I�'�.YO.U{IN'�"EK�D�?TD"�1?BTAIN�F1Ni1��1N�;�UNStl�T
<br /> �`AT D �t� Rt+� O QY i •R� :, - , � .
<br /> F�aR�aA,tur�►���.ttr:� � .,. . ..�. � __.,..:.: -_�_ ,-_- - -�. - -__.-._ - - -- - -- -- — ---
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<br /> OWAtER OR AOgAtT :.�.. � . CtyNTRAGTOR:.�+–�`�—.=__..- .
<br /> 8ubscxibad and swrom M(or afllrmedj before me fhls Subscrib�and'swom�M{ar'a�ftme�drb+�fona me-ttil��
<br /> by .by..., C7/�Y)' _kCl�•r1 C.�-s ,
<br /> I V�fia isla�personatty known.to.me or:haslhaaa,Rroduced Wha.t sre g.e�q�elly:�crtowmto�. ;oc.fiaslhav,e:pmdiiced. • �
<br /> 'as Id"eiitlAcaUori.. . Q�U�KJ /.LL���L/� as Iden�ifca�an.
<br /> Notary Public . .� � o ry Public
<br /> Commisslon No,`' Com Isslan�No._ ��� �tLS ��
<br /> � ��f'�' �1�,4-��� �U�'�'/��L--
<br /> Name ot Nvlery typed*pdnked or atamped Name ot Notary qrped,pdnled at slamped
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<br /> ���Y"~% DEBRAELAINE RUFfELI
<br /> .. � ��,...:�,�Comm€ssian#GG Q45343
<br /> ty����w,=Expires November T,2024 - ,
<br /> ��o,°�; 9ondod3twTroyFaininsurau�ce800.985�70f9
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