i I
<br /> I i �
<br /> ' �onc�oF o��s�cno�+s: rne��tr�s�s pane�me�e be r�t m��s° �
<br /> I wn��y�►�e���cou�ty�a�ons. rne�d��p�y�nr ear�tenae w�ac�+ I
<br /> ���•
<br /> tMa� corrt�ac�s ��eo co��sacra� : �t tne a,�a�n�s t�+ed a �cr l.
<br /> j c�ntrectara to�ae�ta�e►aro�ic,t+�►may►x requir�d eo ts��ea�n axordance,��Ea easd ba+�utaHo�. �ihe • i
<br /> �is nof�ed es roq�ired by.law. 6ot�the o�uner arid�c�m�y he cped.gor a�vieobBWt
<br /> �a�er at�taw. �f are�or��r are�n Ss to����l�r"epp�►ior 9te I I
<br /> lnter�ed aiotk,theY ane sdvi�d to can�ct its�Pasco Caudy�I�s�h�lsion--Lfsxt�efi�.S�n ad T�7-8�17»
<br /> 6009. F�ujrtt�nsmca, H the��j��(�I�jha�sj�horcd�a yc��a�nUga.�c�.o-�r�y c�ra��s��itx{�s,�� he is ad�riae�d Eo l�eu�ep-gf��e�hiaor(s).e�n
<br /> ��W�4��0{ll\� VI UEi'D�{�G3fV1�'!iN VW WI�q{'7 LQ�i �. ���il OO����
<br /> oorwacx�,that rt�ay b�en letdicadon lhat t��r�t p�o�iy f�oensed end��ot et�bed Lo pp�iittxl���aesoo
<br /> ��Y•
<br /> � TRAi�POaTA7ION iYPACTMil.ITiE�NIP�lCi'A�ID itE8C1SRt�it�COVERV F�: it��er�e8�st�r�
<br /> � tl�at Tr�.spertitbn Ir�ad Fee�s and i2�Cotas�Racaae�r Fees rt�y�p�y Uo�1fe t�ot�t off nCw a,�s.dsar+oe a�
<br /> , c�e��tt►;9 t�ril�s.or�ac�sion 6f ea�ir�g b�tdlr��as sp�ed�f'as�b_Cou�y C3�a�o�nu�nb�er_d9-�7:arid
<br /> � 80-07,�arraended. Ths�also�s,tt�t aaxh i�es,�a may be dvo.w�6e.men8led.at we�8n�e;a# � I
<br /> penr�ttrg. tt���der8tnod that Trarssportadon Imyact Fees 8nd ResOtsae R�y feea�!be p�icl.pi}ofto
<br /> I receivl�8 a'casttltic�of oxc�r"or fMal pCwer r�e. if tlae�does reot intwMie a:�d oaqa�enc�l oe �
<br /> ! fi�al povaer r�elease,the fees rr+us!be aaid ariot bo p�rrr��oe. F�tl�Bns�oe�,if Pa�casrly Wblet�w�r kn�Ct �
<br /> f�s ete due.ft�'!►must be paid p�r to pent�t is�uarsce in�v�h 8ppi4�Db Pasco Covtiy En�191�oei.
<br /> COHSTitlJC'TtflN UEN LAW(Chsp'�t 713.Ft�ald.�S�,2a : !F r�4ta�i Cf Mrnfit is:32.600.aE1 or It10i�.! �
<br /> t�rtify that 1, 4he �pR1'Dca�t, ha"t�re be�n proYided witE� a GGpy �f tl1e "F7�rid8 Ca�i�1 IJDn ,
<br /> Pra�cn c�do�p�e�ared t�r n�e F�ari��r�est a��iar�+e and cae�aner l�a. n.�he appi�*ti aac�ea,e �
<br /> o�ar B,a�,a,e-owr�",�c�itr tt�t nev�c�r�ed s capy of tl,e a�do�do�a�nena�vcomMe in pood tai�to
<br /> deE�r n�o tr,e•aar�prior ro«xrxr�rient.
<br /> Eit'S AFFtDAVlT: I oertlfy thet�11 tha irt�rf�fn ttrs eppiie�Of�k9 eodsale aild Mf�8!)wor6t I
<br /> � wdp be done ln c�rtce wt�t aH eppfic�t�laws regtttaSng�rt.za�tU'�g Snd!�d dm�lek�plllee�..ApQi9x�!� ,
<br /> � her�tsy rttiade to abtain a pe�tnit to do woAc ens! irts� a.s �. I.c�[�r that na txqlc�w hl�N9bloe�.h�,.s
<br /> camr�enoed pcia�to issuanoe of a perrtdt ar�d that a�work e�i 6n per�Orrned�o en9et�de�98 at eR��i�d9d�g �
<br /> � �on.Cota�Ny and Ciiy codes. z�r�latior�s, and I�ttt!�n�nt�!�Plle juipl6etlGe�. i ata�,
<br /> i c�i�►tlt8t 1 undBlsiBttd the!ttle r�t�of Otf1c�9���'$PP�Y ED.�ili�ildOtf 1Aafls.8fld 1�f9t�t.iS �
<br /> mY�spar�slbtqty►to ldar�tify what aWans 1 rm�t isboe to 6e fn�. Stach 2gene9es 1tw�ta�ie b�tt a�110t Nr�vi�d�_.: '
<br /> - Depettirt�nt at Errvirotuae�rial Prote�lor}Cy�ss Bsy#�ds.IAAel�rid Are��itd EsroirOn�To�Yy S�
<br /> Landa�Wale.rM/asiea�afler Trea�r�t. -
<br /> - Sot�vrest Flotida Water M2n�f D�l9bte�s. CYP�'� ��. � �'�• �R9_ ,
<br /> � V1Ra�auBes.
<br /> - Amry Corps af Ersg�e►s-S�rd!!s.Doc3ta�R�su4gabl�Wa�ea�a. , �
<br /> - Dep�rbrqrrt of alesith � H� U�llV�s,�uaa�r Tt�eM�me�t,
<br /> � Sep}1C Tars9�.
<br /> - US Errv}m�l Pmi�ion Agena.y-A8l�stag�d.
<br /> ' - Fe�eret AW�tan AutFwrity-Rtsnuvsys. .
<br /> !unde�8ttd ffeat the fa�nrh�ie�tridiatts ap�ly to�uss of AEt:
<br /> - Use of�tf ia rto#altor�sd[n Flaad Za�e'Y�u�ess exptessSy�. � -
<br /> � - �r a� fiH ma�s�l ta to a� e�sea in Flaoa zone °A. it!s �anae�oa tt�e e ara�a.pie�!ed�9 s
<br /> itf�the�a��.��ae time af perre�.�g wtrr�ts�+ed tv�►�p�ot�alae�tenpl�e� i
<br /> i - If the f�1�ma�is to be�in Floa�d Za�e"�1°�n�f:vaifh e Fe�rNE�d.:bt�n�tt�steen!�I. I
<br /> ' �,I cestify tl�a4 6N w�l�u�ed onfy to�!the 0��!b a�rn ulBD.. . ;
<br /> - If fi!! rr�aterial is to be used In a�ry ar�, I cettiiy th� us� d svdf�va� nof:adueesaljt.elfeGt,a�'
<br /> properti�s. tf we of fl�is tourx!to aduea�,.e�y�2�}a�3 D�DD�.�fe v�fer Rt3y-bP�t�lEd for,lt�OF�C1g �
<br /> the�o#the bs�itlg pemtit'tsst�ed tr�x tF�e�pes�idt a�ort.foY IGb b�6 tlf�eb Ot16(9) I
<br /> aae whkh�els+rafed by fdf�an e�r�d d�Pl�vt is te�d. . .
<br /> ' If I am the At�liT I�OR 1'HE'GiI1PKER.I�omf�in gaod fa�to irt'tDrm the orwtet of th3��i8t i�fllllst. '
<br /> d�ts at�d�vit�ior M corrvr�ertdng ccu�strtr�lon. I urideratsr�d ttsat a s�ara�Pertn�m�r'bg neqtelred.ioT.e�_wr�, {
<br /> pltxr�. �.wr�ts. �, dr ear�ditioning.9�, or other �eot spec�t�3uded irt t�9�pplCl�dn: .A '
<br /> perrt�it Esau�d shatl be c�r�d to be a Gc�r�to pro�sd wtlh the va�rtc snd rt�t��leo�Ety►ta v�o�.ealoEl,slkM':� ;
<br /> set sside arry Provlsfans of��ca!e�es,rror Sh�isa�t��a,Pe�P�������
<br /> �4�9 a cor�on o9 errors in pl�s.�os�or alda�Ores oi�Y�Ss• Ev�s',Y pesr�I�e�d s�ili 1f�(�n?i�ri�i�i I
<br /> unieas the mr�ic autho�ed ay sud,pemsn Es��,s4x rroc�a-d pmir�l�,'�e�s.cr Nh�ak aR�e ffi� I
<br /> the pemdt Gs suspe�ded or aba�sdor�d tor a petiod of sbt{�montt�s.�ber�iime.the u�t3 oo�eaionoed].�lilq�
<br /> q
<br /> mey be�qt+es�d,ir►wrs�g,fra�n tl�e 6uz�ng offiaaf�or a p�sfod rrot to q�aoeed N�►t9Fi�de�a and,wi��nbna� �
<br /> }ustifla6te ceuse Tor the extertaiori, if work c�ages fOr r�rre4Y(80}o�as�na dapa.�e jab is eot�siderad aber�dor�ecl. I
<br /> WARNqlG TO 01�IMER: YOUR�AtWRE t0 RECORD A tt�E�F _ il�r R�ll.T�1 Y� ;
<br /> � PAYtNG TNRCE F��PF;01/��1�l1T3 TO gAU�t�AP�t'. !F�IN�ID TQ:�OBTAIFI�tA9�i�,�t�.T , I
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<br /> ! �«�.� ���.�-r��� l�i IQc�h6� ;
<br /> , s�oe�mwo,,,to cor a1fi�,�a�b�oan me t� t � �n m cor a�b�'c�e ms�� �
<br />, , wno�stre personc&y b�+►m m�w� P�Y p�abn�o nra a;� ,
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