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<br /> ldOTICE Qr��DEEQ RE8TRIC'CION9�:. The.qndersigne�fi;under�tands��h�t�#his:;.��rm�f,:i,»a�y;;be,sub�ect:ta"deed.".-rostr'Ictiaris",::v.,,.,,.
<br /> .;.. i' . . ,... .. ,i.Siy t �a "� "v.,- � '' :�a i�; �y �' S.f�err:s.':.. j +`:i"`.s.•.�i.r,e;t.'.t��i�
<br /> which may.tie<mare��r�"s"tFdctlVe`=ttia�t'Gounty�rsg�iletPon's:�.i�na�u�P+aer���r;a.a'�i�s�um�s r"espons�blllty�fo�compliance:with any
<br /> appllceble'deed=reatttctions. .:{>,;.�.;-::,,�`:�.t�� ' � __:. . ... _ .._ -- - ��::�.:"'`=�`�='`T'
<br /> .; . -•. �;�.�. .,...�.... .._ .... -:E
<br /> UNliCENSEDt`�CC►NTRACTORS°AN� CO�NTRACTOEt RE�iP�N�IBi�ITiI�S:=�.-rrlf�t�e�auvner�has"#iirecl"°a:"ct�r`w.ti��'ctor ar
<br /> contractors.to undertake work;:they m` �"�``'
<br /> ay.ibeireiqirir;ed.stti:;lae;llcense,di�lrt;accor.dance:withr;state�andk local'�r+�gulaNpns_'«�if�the����:��°
<br /> �N„__ . . r.•.. ' '"'.'�;
<br /> contractot=fs'•nat-llcensecf:'as==tequl�zl;'tiy law,•tioth��th� owner a;nd-�co�at�actof°may�`tie�'cifeif�for=�a�ml�derrieanar vtola#1an
<br /> under state law. .If the awner.ar Intended>,,cont„r;�i,�tor,.ere„uncertain �s:to.what Itcenaing�,.requlrements��may���apply f�ffir�tiie��-�����:�=�';
<br /> fntended'work, ttiey are:edvlseii"t_o ciantact ttie Pa�co Cdunty�8uildirig�Inspectibn l�'1'vi�lon-L•Ics[�,,s"Ing 8ection at.727-&4�7-
<br /> 8008. Fu�tttermare, if tFre owner`#�as"t�ir�+d a ccin�actar'or contreotors. he Ts aiivised to have rthe cort�+tracta�r{s)�,ssfign,=,,=+::�;��y •
<br /> portians of the "conttectar.Black".of.this�appllcationMfo_r.;,which,:they:wil�:,:b.ea.r,espor�sible..�If.you,�as:the owne�r signg'as the
<br /> contfactor; thet�r►�y'be an indica�on tl�a#'Fie'�1's`i�iot`ptoperly„Ilce�isei�'�an�"'ts'"not."+eritl�eil fa perml�tiiipg..p�tuileges ln Pasca_. ,
<br /> County. .�. _ . . .. . .. ._.._ ... � ' ...,........_..�:.�:_...........� y4.:�>��:��..�,:�,:�
<br /> TRAN�PORTAT1t�N.iMPACTIUTILlTIES>[NIpAC��Nb�l'tE�AU�CE RECOV@RY fEES:"The°unde�sl�ne�"understands
<br /> thatTranspar#etion impact Fees;and.Reco.urse.Recavery.fees,may;app�y�atn�tt�e�constntctlan.�:of.new�b.uildings��change��iif�°?�`m"�==="�`�
<br /> use in exisNng buildUgs, or.�exp�r�si�n of"e�fati�,�:�bulliNngs, as speclfled.In Pasco County Or�linance number 89-07 �nd
<br /> 90-�7, as amende�d�;.;:.'�he undez�lgned a�so;.�ndersta�ds; thait�;such fees;as�majit:��rRduerhw111�=be Iderittfled a#theRt��ie4ofs��-�:.4���`
<br /> .�_��_...
<br /> permilting. It Is ftirthier underefcod that Trai�i�p�o�tation Impact�Fees an�`��Resourc�:�Rec"oiisry�Fees`�<,mus# be pald prlar to
<br /> rece�ving-a"cerfi#ica#e._of occupa�yy"':ar�firtal�power�eleasers..4�the.project=.does:no�tnvofve:a�r.�rt#�cate af occuparicy�OTa�'K�.'"'.''a`�
<br /> .. _ _ . :...
<br /> finai powe��release;�ther:t'ees.ii�u�.t;�tie p�id;;p'r`ior to,,ermit issuai�ce. F�itthermore;,-iE�Pasco��Coun �WaterlSewerf:lmpact�.,-;;��tY:=�
<br /> . ,,P::.� ,.�.�>, . .,..:.,.,,: �',. .
<br /> tees are.due,.theyWxnust;be;.paltl=p�lor ta-,permit�lsstlance°:�n,accocdance with:applicatile:Pasco'.iCounty,�ordtrtances. �
<br /> Ct�PtSTRUCTtON`l:fEN"[:AVN�Chspter 715,Flar�cla Statutes,aa am�nded): tf vaiva�on of work is�2,500.OQ#or morre;.,}:.�,�. =;�.i;.
<br /> .,...
<br /> certify tliat I� �he :applicent;:-have,:beer�. pravtded��with a-copy--,of`�ther�"Florlda��ConstFuction,Lien�,.Law--Homeowne�'s
<br /> Protectlon t3uide"prepared by tlie'F1�if�a DepecEme�t�of Agrlcutt�re and Consti,m�r,-Aflal�s. 1#Ehe appltcant is sameone, ,,. -_:�;-�f
<br /> ather than#hQ"owner", I certify�.th�t l�.tiave�abta.tned�akc�ipy.of:#he:ab.Qva:rles�c�lbe`d:�ocui�entand:'p�misi�`In;g'o.od;:falth�:to �- .=..s
<br /> dsliver!t to.ttie.'owciei"p�iot-to���comEiiencement:`; . _ . , .` � .. - �. . . " - . , . . _
<br /> GONTRACTOR'S/OVYNER'�A��IDAViT: i.certtfy,k#t:��#>��ft:th�e,infiormatian:�in-th1�appltcetion i�accurat�.�nd tha#ali wark
<br /> will'be done In compllance.with all.appllcable laws regulating aonstructlon, zoning and::land`'devetopm�nt. Appllcatlon,Is ,
<br /> hereby nxade to;ob#etci~.a.permlt��to,�do:woflx;,and;l�istallat�on as Iritlt�eti�d:f-=�=;lk certlfj► #Ftat no wa�rk��or tnstallation tias;
<br /> commenced�p�lor to I'ssuance of'.a permit°�and that�:all��vork wlll be pertormed�ta meet-standaTds�af�all laws regula�ing� '
<br /> constnlatlon, County and City codes, zoning regulatinns� and land development regula�oiis�in�tiie�jtir�sdtct#on:==`i-�a}'so:
<br /> aertiiy that i under�tend that the regulatlons of ottier�gavernment agencles may�apply:#o:.the�lntended.work� and that tt(s "
<br /> my responstbll(ty to Identlf�►•what.actlons I.m�ust.takei;to,be,;ln compllar�,,ce.��#S,uch{agen,cles�lnclude�butaa�e:not Ilmtted to:,� ��� � �
<br /> - Depar"tment of Er�vlronmentat=�Protec�ori=Gypress'Baytiead�� 1Ne�and Areas and Envlronmentally Sensitive
<br /> Lands,Water/Wastewater Treatment. ...,� , , �, ' ;��}� � � .-
<br /> - South�uest Flortda IlVater Manageme'i�t�m:1�[sfr.Ict:We11s;�'=Gypt�es.s.'..8�yk�esil�';� �Wet�and' Areas, Altering
<br /> Watercourses. ` -`'; .•.:t :.r,,_:�� ;_ ,.:�r,,., - . �
<br /> - Army Corps af Englneers�Seaw�ills,'Docics�Navlgatile Waterways, -
<br /> - . Department, of;Heaith€,&<<Ret�abititat�%e�,,Se.niices/Envit+onmentai�F#ealth�11hit:Wetts;�V1�asteuit�iterz Tre�tment;
<br /> Septic Tanks;... '�'`:' _ .. . � ' • - _ v .
<br /> - US Envlronmental�Protectlan Agency:Asbestos�bate.men� �
<br /> Federal�Avlatbn:Authorltj►:��Runways�:�� '�
<br /> f undecstai�d.that�the.tohowing:3irestN�tlons apply to t6ie use of flll:�
<br /> - �Use of�tl is nat aflowed in:iFfioodl,Zone"V"unless expressiy penmitted.
<br /> - If the�zflll�miat��ialN-ls°�fo'�b'e�use�l:`�In.:Flood Zone. "A", (t Is under"stoad thaf"a dralnage plan addressing a
<br /> �compe�sattng volume".wllt be submttted at#ime of.peFfnittt�g whlch {s prepared by a prafessiana! engineer�"
<br /> Ilcensetl.by-#he;�tate�of�Fl6Hda: � � -: �- .
<br /> - tf th� �ili>��meterlal�.is'ta be;used In Flood Zone "A" lra�connectiot��with���ermttted 6�itding using s#em wall. ,.
<br /> � const�uctlon, l certi ;tfiat�,flit:wlll:b.e-used onty.to.f111 the area�withln�the�stem��wall: � � � `
<br /> . �`Y, wa
<br /> - If flll rri�te�lal`.Is to be used-�ln•.any area; 1 �aertlty..that .uaa.of-:such flll wlll not adversely atfect adJacent : .,
<br /> propertles,, tt':us�:of filt:is.fatind:#o.,.adrters�ly:..�ffeat adJa+�ent�;Prctpertles�.the awner may be ci#ed for ariot�ting..' -
<br /> the cond�lons.of�t�e bi�llding�perrrilt-�I�sued>>u�de�tha`att�cfied._�ermlt�appllcatlon��for:lats�.le"ss�than�one (1)
<br /> acre wliicli are e[evaterl��6yAfl11;_a�t englneersd dr�lnag�plati is required. �
<br /> If I am khe Ai3ENT,FOR TM���OWNER,;I�.promise,In:good,.falth#o Inform'4he��a.wner.of��the permltting condl#lans set forth tn
<br /> 4hls affidavtt prlcr Co comrrier�cing cvnshvctld�. �I understand thet a s�parate�permlt may be tequlred for efe�trlcet:wark. .. _.
<br /> plumb3ng,:signs� we11s�.,poois,. eit'.t�nditionEng;=:ga�sr oc.ott��r:. install�#ions nat.spec�tcsatly included�fin.the apptication. .A -
<br /> permtt Issued shall be aonstrued to"be'a`Ilcense`�to�'proceed wtkh'tNe,;viiock and�notrvas:authoHty�b:,.vlolate;�-c�ncel,�alter, ar
<br /> set aside e�jr�provlsEons cif the'teclinlc�l.c.�des;,nor shalt Issu�nce�af a.permtt.prever�t th�e 8ulldlrig Ctft�ciall'rom thereafter
<br /> ,....<.,.,., .
<br /> requlring a cocrectlan�;ai;errors In�pians;.consUuctlon,orvlolatlons of-any�codes:��:��rery-�p�armtt��I.ssued�stialF-6eaome�-invalid
<br /> unless the work authaNzetl_by sach perrtalt:�(�.cotrtmenced wilthln,s�.monlhs of�permlt l�su�nc+�. or if work authot�zed by �
<br /> �.�;.
<br /> the permit isssuspended�ar:abar�doned:far:a,period�of:-sGc:�)�mant�is�aftet�the tir�e.the�wotk�Is commen�ed., An e�ctensian
<br /> may be requested� In.wriflin`g,�from_tHe;Bulldtng,Oifl�clal�tor� perlod�not-to exceed'rnfnet�w(90)`day§ ai�d4ini111`dernanshate
<br /> �ust�3able'cause fior.�#he ex#enston. If work ce�s,�>for nitte#y.{90}consecutive�dax�._th\�ob�is consfdered a�a�donei�. .
<br /> � a � �- .. �.- 5� ..,�. _ �
<br /> WARNING TO 4YVNER: YOUR:.�AIl.ttRE;FTt1..-RE�Q�tQ.A��14'��6E�:O�:�C�DMMEM��!lE�WT;MAY�RESt1LT IN�YOUR .
<br /> PAYtNG TWiCE,FOR�iMPROVEMEN'fiB�.T;O:Y:0U1:�:PR`t��ER�TY:`�I��:Y�OU;1�1'�`E�ID+��T���587'AIN"FiNiA�1�1NG�;�ONSUC.T
<br /> WIT AN° O� �. 1, •R�1 . ' � ; ��: - , .. .
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<br /> aww�a aR ao�et�r �.. cc�t�r�e►cTo�t . -- l�/�,..��;,� � - — --
<br /> Se crlb and swo M or a�In»ed}before e fhls Sub b erad'swom-to{ot affinned}�b�One nta�tMb . '
<br /> a! by �.c-� i.�a1.�n.r� ���?�1�::�._ �..�� �.-��:�,�2�__ �
<br /> o tsfare personallylmown to•me. . -Who.ls/ere;p.ersonalty,lmown�to•:me;,eHiealhav,a�pr+�i�sad• •
<br /> ° as l��ri��attpri:` _ - as tdentl�catlon.
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<br /> _,��„���,� � Notary pubtic . IVotary Pubtic �
<br /> Co misslon No•: Com�tsaton�FEo._ ��.f���,_ �.�/�
<br /> ��f��k���C.L ��L�r���'c�'�"�.---
<br /> Name of Notary lypedt pr#nted or siamped Nams o!Notary typed,prtnt ed
<br /> . ..:��.x_a—= _ -- � � "
<br /> :�i��'.'�;�. DEBRA ELAINE RUFFELL" � ;:�+,.��,�I`�`a D`ni'�t E�Lq��RUFFELL
<br /> •.�: 'Co
<br /> -.' s�`� : .Commtssion#�G 045343 i�: ::� ,_= y�ira�;�!n�# G p��q��
<br /> •".�'r�}�P� �n�ires Navember 7�2�20 • ���:;�`�c�~�o�daa Ttr�T yvmbar 7� +"�0
<br /> . •, 4,:;;;c'��;�r.+•_d�hru Troy Fain Insurance 80a395�1019 x. +�Y F�In Inaurnnw�mts
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