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<br /> N�'�tGE��F DEED.RESTttiCT10�1S:. The.unde_r:stgn�d;under�tandsr:th�>�thl�?.��rm�f;:�nay..l�e.sub�e.c#;to,��deed���estrl�#1o�►s.:...�.,�,
<br /> which may;tie<more��restir�ctive�xth��t�Caunty�i�egri.lsitfons 'The un"d'ersl,�ned''assumes�`respnnsi�bittty�for.compliance�in►ith"any""`�"�`�`°h�
<br /> appllcatife�deed=res#rlctlons. =��e�.�.�.:.�� .,y;.,�f..;: ,r�.�. :�. `�' - .. . .. ._,__. �. ..,...M.�..... ..;� �r'�,_;�. � ��:���-�
<br /> UNLtCENSED�`CONTRACTORS��AI�D CCMNTRACTOR�RESP�NSIBiCiT1�S: �=<if-�iie��owner�°�fias°'Fitred�"a`;cdr�fir�ctar or �
<br /> contractors.#o undectake work�-they riiay�bo�requli?ed:to;�1���Ilcensed=lrt..accardance.with,state�.and�Iacal�:re ulaN.' .��� �°�Y".'
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<br /> g�_.. �ins� -1f'}the��•��'
<br /> GOAtF'£�C#Q[TS`ROt�IICBt}S@tf�88'�re'qt�ii�;'6y�liaiiiv� tiattt'=#he awner arid'cont�ictoT��may:�ties.clteil4:fo���imtsdeiriesnor vlolatton
<br /> under state law. If the owner.ar intended;p,conha�tor;ar,e;�uncertain �s`to va+hat Itcenaing,;,reyulretnents;�mey�jeiipl�iti�for�'tiie��;�:�:�x-i7�°�
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<br /> intended�wortc, ttiey aTe;ativlsetl ta�contact�tl�ie�.Pasco:Cou�tty Buitdiitg:lnspecttcn�Dlvlslarta-1,.[censfng Sectlon at:727-847- �
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<br /> 8008. Furtliermare, ff�#he oitiner`t�as�'fiir�i+ii�a�conlrecfor`or coMractots� he�ts advised to fiave�,tfie cant;acto�r(s)�sign..`,���,,r�,y
<br /> portions of the:�"contrecta�.Biock'.of,,,this.tapplicetl�n�for.:whlch..,they,will:;be�r,e�ponslble.-.�,:if�you;�as.�#he yowne�c;si��gn as the� '
<br /> contractar;tF"tet�m�i be an Indicatiart Niat'Iie�is'not.properly iicensed antl°�ts"'~riot`en�tleiil to�reimilttli�g priitlieges in Pasco .
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<br /> Counly. . , 5,..:�_. .,., .,
<br /> TRANSPQRTI�Tit1Ny1MP!I�CT/UT!!It'!ES}!�'It��C'fi���l�Nf?��tESOUItC�REGQVE[tYfEES:"The�unde�sl��ei�understands
<br /> , thatTransportatlon Impact Fees and.Reco.urse.Recovery.Fees msy;�p}ily:�tc�ti�e;construction�of new..b.ulldtngs;.change��of�Ai�`�=```=i�"c'.
<br /> �use in exisHng buiidings���or.�exparialbnr-of�ekisti��:'�buildings,as speclfled.in P�sco County Or'dtnance number 89-07 and
<br />,f' 90-U7', as amended,;:,Th� underslgned also;i�ntlerstands; fFiaifi�sych tees;as�may�;�r.due�xw11F�6e.idetitified at the�tii�ie�of`��-��"�"��`
<br /> permitting. It is fiu'rtiie�underetood thet Tre�isp�o�tatlon impacf'`Fees a`rtct`�f3esource�Recoireryz`�ees:,must be pald prlar to
<br /> rece�ving�a"certEficate=of�occups�cy"�or fln�l-.power-�elease."�:1#�th�pro�ec#.;does.�riot 1nvolve:a;certi�cate of ot�upaticji�o���'-"•:.p,�.�ts:y
<br />' final awer�release���ilie;fees�iir�r��t'tie atd. rlor#a; ecmft Issuarice. f�xtt�ermore;•ff:Pascc�,,Gounty"1Nater/Sewer.:�.lmpact �. . .
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<br />� fees are due,:they.>m.ust:be;pali�`'p�loc.�a..permtlhlss.uance°:In,accordanc.�wlthr�:appllcalile�Pasco�:Gounty:oiiltnaaces. -
<br />� �ONSTRUC''CION'�.IEN L,AVIt tCliapter 713� Ftor�da Statutes�aa am�and�dj: ifivalua�an af work ts$2,500.00$or.�mor�;,,M���i1 =°�_:
<br /> certify that-I, #he�:applicant;:;have�been providetl�with� a=copy��:of;�the��"Florida-°Constructton:��Lien�.`Law Homeowne�'s
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<br /> P�otectlon Gulde" prepared by',=`tFie Fl��ds Departmecit"af Ag�taui#�re and Cansr�m�r;;kl�~alr`s. If the appllcant{s someone:-:;,..: �.:;--�}
<br /> ather than the"owner", I certifj►,,-that:,l�:ti�ve,o�t�ineid"a=copy.of:#he:abQva:rlescritied:�locu�enttand;p�:ot�ise;:in;good�.falth,to , -�:S.>
<br /> delhret IYto�.the:'o�rrier.'<':`prior�ta�:�c�tnnierii�rtterit:" s . ` .. � . . ,.. . � _
<br /> �ONTR/1CTOR'SlOWNER'S AFFIDAVIT: i.ce%tttjr;;tt��t�ati,;the�g{�mnattontl��thi�appiicatlon ts accurat�.and thatail�work �
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<br /> will'be done in compliance.wikh all.applicable�laws regulating constructlon� xoning and:�land�°developm�nt. Appli+catlan,is
<br /> hereby made ta obtain:':a.petmlt:�;�to,:.do;w�f�k�,and�:tf;istall$tlon as icid{�eitt�.il:�=.�°I� certify #hat na work=�or instafitatton �Fias- � .
<br /> camme�ced p�lor b issu�nce of`a permit"and that�:all work will be pe�formed�to meet�standards-of�all I�ws regula�ing�
<br /> consMsctfan, Gounty and Gity codes, zoning regnlatlans� and tand developmertt cegt`sta�ons�'tn tfiie J,i�rlsdlcfion.t��'t�al'sb- -
<br /> aerGfy that 1 uader�tand that the regulatfons of other'gouernment agencies may�apply::#a:.the..lntended.work, and that It ts -
<br /> my responstbll(ty#o(dentlty�what.actlons l,muat:teke,:to be.fl��comp��nce T�Su�h;agen,clesilnclude�but=ate.nat limited to:: - �
<br /> - depai�tment of Efiviranmentat�Protectiori=Gypress':�syhead�� WeH'and Areas;and Envtronmentatly Sensitive
<br /> Lands�WateNWastewater Tnalment. - �� �
<br /> - Sout��uvest Ftar�da Wa#er Managemenk::.:t�fs#r1c#.-Wells;�'Gyptes.s.�Bay#�eai��; �VYef#ar�d� Arees� Atter�ng ,
<br /> Watercaurses. � ':I .;:,.;,,,�:�.; : ..,, , _
<br /> - Army Corps oE Englneers�Seaw�alls;Docks,(Vavlgatile Waternays. � , -
<br /> - Depar#ment..of.,Heaith,�,B,:Re�iaGllitativ�;.Se,niices/Ernr.it+onmen#al�F�ealth-Untt_Wetts;�V1Eastewater�TreatmeM; '
<br /> Septic T`anks:.. -�.} . .- �� ..... ` . .. -
<br /> - U5 Envlronmental Protectlan Agency-Asbes#os abateme.nt. � .
<br /> Federal AvleUonrAuthority;eRunways:� � •
<br /> 1 understand.that:the.foltowirig�restrtctlons appty fa ttie use o#flll:
<br /> ' - �Use of`flli ls not atlowed In�Ftood=Zone"V"unless expressly permitted.
<br /> , - If the�•fll! mateital�-ls�4o'�b.e �use�;!i►..Flood�2one. aA", tt is understood that`a drainage plan addresstng a
<br /> , "compe�sating vatame*;will be s�bmitted a##ime o#�permitting w�ilch is prepared by a professtanai engineer:. .
<br /> Iicensetl by��he:�tat�of:fiotida: �.. - - _ _., .�
<br /> - If th� #Itl:�.meterlat-ts�`to:bat used in Ftood �one 'A" in�connectian�vdrlth:a��ermltted bnildlr�g ersing stem wall.. .,
<br /> ' constnuctton, I certify:that:flll:i�rall:b.e.used only.to;fill#h�are.a�within�the�stem�watl: � � ,
<br /> - � !t fll! mateilaf..ls to tie used-In ariy area; 1 �asnity that:use af•.such f!!1 wlll.not adversely atfeat adjacent . .,
<br /> propetties. if.use:-of flti.is.fonnd#o.-advers�Fy:,�ffec#adja+�erat�prctperties,.the awner may be citad for vl�ating. �
<br /> the condwons�of,:the bulldimg;perrriit�is�sued�u�der tlie:fa'ttached�ecmit_applicatlonR-for:lots�.less�:ttian:one (1�
<br /> acre w�iicti"e�e elevated��tiy flll,��t engineer-ed dralnage ptan is requlred. • . �� .
<br /> If I am the AQENTr wOR TM��O'YVNER;,I�prorrtlse.ln;good.faith ta Inform��the awner.of��the permitting condRlons setforth in
<br /> thls affidavtt`pr3or Ea'�commencing constructlon. �i utiilerstarid that�a�s�parate`permlt may be required for etectrRcai�.wark, -. .
<br /> k.�,.�,..�
<br /> � ptumbing,;sigros� weits�,:poots,�alr�:.conditioning,.g���::or.o#heT instell�ti`ons nat��pec�fcally included-in.fhe�application. �A . �
<br /> � permit Issued�hall be coitsitrued to"b'e a�license'to��pr'oceed with°ttiewViiork and�;not-as:authoNty::to:viblate;.-c+�ncel� alter� or ,
<br /> set aslde ai�y�provlsidns of�the:t'e+'chi�Ecal.cades;;nor.shalt Issu�nce�of a.permlt.pr.event ttre Bulldirig Ct#ftdalfrom theceaffer
<br /> '' requlring a car�ectian af-errors In�.plans;:cons#ructlon.or.violations of-any�codes:�-�v►ery�`p'ermlt��issi�ed�stialf tiecome��invalld
<br /> uniess the work autharized_by such permlt:�s-commenEed•withln sf�c„months of�permit I�suance. ar!f work ae�thorized by '
<br /> ' #he petmit is.suspended:or;ebaradoned�for:a;perlodr�of;six:�8)�manfFis�..aftet�the�tlnae the�wotkds commenced.. An eactensian
<br /> i may be requested� In.writlrig,,:.ir`om tfie;Building,Offlclal�for a perlod�.nnt.to-exceed'=ninei�r�(90)'��ays a�id�wlll"demvnshate
<br /> �ust�iable.c�use for:�the e�ension: tf v�►ork ce�ses:for nlne#y.{90}�oa�s.+act�tive:day��..#he�job�ls constdered aba�di�ned. -
<br /> IAtARNlNG Tt? OWNER: YOU�_�AlI.R+tRE:TtI,:l�EdCQEtQ.�A��.Q��1GE�>QFwCQMMEMCEME�#T>N�AY�RESU�T IN��Y�UR �
<br /> PAYIN6 TWI,CE:FQR��IMPROVEMEN;��•.T�t�Y�O.UR�:PRCC��'ER�TY:>�tE�-Y0U;1�1'�EWCI��TG:rY�BTA�N"F1NiA►�IEiN.C�;._C�N�ULT� -
<br /> WIT - - [1 �O::EiI�- TT8 6�'. 4, - — k� ;g � ;_ _ ,> . , ' - .
<br /> h't.flR10A.lURA'��{FsS::11Z:Q3�: ,. . . . . �>. . .-.. � . .... _ -, _.. . ,.., >:�:.,_ ,, _ _ ,..
<br /> OWNER QR Af�EN7 . CONTEtACTOR �_•)i�� �-----'`�
<br /> 8ubsafbed arn!swom ta(�a�irmed)befor�me fhis Sub�cxlbed'and'swom��{ot'aflJnnedpt��tote rtta°tti1S .
<br /> by . _,�by.... `_� ,�,..^ fi'C,s�.1�..ci�t � ,
<br /> 1Mlo Islare persanaliy kr�owm to,me.or:heafhave,produced Who.ie/are:p.ersonelly.knowmlo�:me;or#leailhhave:prodiiced- •
<br /> es 1d"eii��a8pn. es tdentNicatton. .
<br /> Nobary Pubilc . � Notary Pubtic
<br /> COtTi1nlSSI4ii NO': Coinnt�Isabn�No,
<br /> Name of Notaty typed�Prtnied or stamped Neme oi Notary iyped.Printed or stamped ,
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