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<br /> 9dOT1l�E�F�Dl�ED RES'�RIC7'ION$:. The:un,dersign�d'under�t�nds��rth�t;lhls�.��mnit:may:be,subJect.�to..xdee.d,.:yfes�ctlons4��..�..,,�:�...�
<br /> whlch may`:tie�riio"r��"r.i�sttiative'�t#i��i�Caunty'r�g�lat�on's:�`°Tii�a`�unde�slgned��s�umes�°responsfblltiy'for"carnpliance vuith�any`«""",�``"�`
<br /> applicalite:deed,restt�cfions. " ;.�.,;..:��..;;yn,.���-;��;�.,,;,, ,'*_....__.,._'...�-....,.. _ --� ,..._,,a �..-., .
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<br /> UN�tCENSE��°CGNT1tAGTORS°:ANb GON�CT�R�RESPO�f�1�i�iT�E�`s���{f=�1ie=°er+vner��has'iiir�rl�`a`'cdiw,tractor or
<br /> contraetors ta undertake work.-ttiey may�bsi�ulred::foK#���Itcensetl.IR:�ccartlaitce:with;state�.snd�tccat;�re ut tio�t�s:�"If�the,�z=., F°��
<br /> contractor=ls-not�llcens�etl��a���re'�uirei!`b IaVr doth�the"owner ara�r�confra�tor�m� �?`tie��'clted=�for������r»1�deme nor violatton
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<br /> under state law. If the awn�r.ar Intended}contra�tor;�ere:uncenain,�s to.wh�t Iicensin�;requlre�nents�may�appDyr:Yfbrdtt�ie���-w���=���'°`
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<br /> intended"worti,�tiiey are"s�dvlsed�to�;contact th�<,Pasco County�Buitding;in�qecflanYDN�,elon-Ltcensin�g Section et°727-847-
<br /> 8009. Furtt►��rnore,�if the ovirner�'tia���hlr�d ��c�ii�tfractor or cantractors: ha is advised #o hav�`'tFre contractar(s)��sign.,�at��'�.:.����
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<br /> portlons�#the.:.contr.actot�;=Block" of_:thle=eppltca#bn�for:whlch�.they,uufll.#te�tesponslbfe ,,,[f,:you.:as=:;tlae ririwne�r sE�n a�th�_
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<br /> contraotor,that�naiY be an indicatlain�ttiat"he Is"not'.prop�ely ltcen�ed"ancl~`ls'"not en�#lei�"to per�»Itt1�g pri�lleges in Pasco �
<br /> County. . �; Q-�,w��;��::;<.��.�;r
<br /> TRE�NSPC►RTAT10Ny1MPACT1UTi1:1'flES�iN���1C�'-�Ifi�b�itES�llitCE RECAVERYfEES.•'T'�te�undei�l�ned�'understands _
<br /> that Tr�,nspartation Impacf Fees and,FEeco.ucse.,Recav�ry.Fe�s;tnay�apply��ta�fF�e`�cansbuction:af new bulidings..3change:iof��.z�>`�;_,'�'
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<br /> use 1n exlsting bulldings,,�r.=exp�r�sf�r=o:F�e�ils#i�i�'2}�ufltfings; as specifled.ia� P�sco CouMy 1�dinance number 89-�T and;
<br /> 90-07, as amended.::,;'�e undet�igned also.u�i�erstat�ds; tli�it��such fe�s;Aas�may:'b�a:xd�e„�vet#ih:�e.Identt#ied s#the"�tl`r�ie�'ot=�='L.ry$�'��;
<br /> pecrr�itting. It ls tiirttier t,nde�sfaod that T+ra�isporkatlon Imp�ct�Feea and�°�R�sourceaRecoii.��ys'l=ses::mus#be pald prtor to
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<br /> rec�ivtng�a certlflcate.�of�occupa�cy°:or�flnal�.pawer:,�lease��':I��the.p1'oj�ct::dwoes�:not Irnrolve�a;:certlticate of occupancy��or-.�-�:°�°:_�.��
<br /> final pavi►i�r.�releese;;iF�e>;fees lnu�t��be paid pr�or to permit is`su�nce. �F��ther�rnore;�.1f::Pasca�:County 1Nater/Se�rer.rlmpact��-; �;��:,•:�
<br /> fees are d�e,;.they�must:beup�lc�;pcfior:#o,.perrr�itJs.s.t�ance=:in.a_ccbrda�nce:wit�,:appllcable.Pasca'�Gounty��ordinances. •
<br /> C�►t��T#t�lCTlON'LtEN'�L.I"Q1V4t(Ghapt�r 715,Elor�'c!�St�tu�,�am�nd�j: tf v�fuatlon of work Is�2,500.OQ�or�more;;l��:t;. �._,,
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<br /> aertify tHat-.I; th+a���Ppltcant,.have,.,beer�. provtded�with-°�•-c�apy�.o€_ther":Eloiida-�C9nstivction;.�fen�`law-�Hom�avvne�'s
<br /> Protectlon Gutde"prepared by�'tt►e"Flor�da Dep��ent:of Agricultt�re and Cdinsum�rj=�kffairs. 1#the appflcant ls.sameone;.;.._.j,.= .,�
<br /> other than the`qwne�' i cert th�at:�i�.h�ve.o iined�a�cq y;of..#he��abo�e:��des.crl �JaFcu'�e t=a f.fa . ., _.
<br /> � KY�; _. ,bta. P K_ . �'�e`d: _...i� n�_ nd;'p:r�ri�ilse;;ln;gootl: ith:to . ;:,
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<br /> deliver it to:.tiia.�'owner�°pi�oi`#o�corn'imencemen�:'t'� . - � - _ • , _..
<br /> t��NTRACTQR'S10WNER'�A�fIDAVi7`: I.cert�jr�•tt:i�t:.atl.�th�;irif.orrnatitm:,l��#Fiis appticallon is accurat�.and that-all uv+ark
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<br /> wl!!'be done In compllance wlth al1.apptfcabfe laenr� rggiilaNng construc#ian� zaning anil;tand'=deveiopm�nt. Applicattan.is
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<br /> hereby made.�to�obtain:.a permit:��to�do,�-u�a��;,{and��`tt�"stalMatlon �s lrid[�ete�;�=;w°I� ce�ffy that no wark��ar tnstaltatloii�°#�as:
<br /> commenced p�0ar to Issuance of�.a' permiE��ind that�:all work wIA be p�rto�med�#o m�et:st�ndaa�rcls-�a€<�1! laws �egut�#1ng- '
<br /> constructtan, County and Clty codes� zoning.ragulatians, a�nd land developm�nt re�ul�itlori��"tn''ttie�:j,urlsdtcttori:��'°!';a!'so� �
<br /> certify#hat t understand that the regulations �f athergovernment agencles may�apply:,to:the:�lntended work� and that tt is
<br /> my resp�nsibiiity��Itlentify�wh�#.ac�ans Ikmust�t�k,e;.to.be�in;caotr,�pltar�cs.,;,S,uchyegencles°Includ�i°but�a�e:not limlted ta:.� - . ,
<br /> - Dep�r#men# of Etivlronmentat=�Piiotectlon=Gy�ire`s�`��yiiead�; {t�/e'N`end Areas and Environmen#atty Sensiti�e
<br /> L.ends,WateNV1last�+ra#er Treatment. � .. . _' -
<br /> - Southwest Florlda W�ter Mana emerit>='C�Is{Mct:.IMep`s; ; ptes�.�Ba ' " .:�
<br /> 9 t%Y, yliieaiisr,_ IIYefland� Ateas, Alter#n�
<br /> Watercaurses. ;�yr.�., ..-�;�,. ,_� .',:.' ;.,4::4`:�`, ::r � . ' � ,. , ,
<br /> - Army Carps of Engtneers�Seawalls;;flocks��lavigatile Waterways. _ .
<br /> - Depar�men#:::of�,Hea!#h;�.�:�xRet�ab�i�ta�va.�Serv�ceslErn►ironmenta{�-F#ealtii�Unit=Welts,h�VlFastevKater;�Tre�tment; �
<br /> �Sepflic�Tantis:..' .._ .�. . .. . --' ° - . -- :
<br /> g US�r�vir�no��nt�!Pro4�c�ur�Ag�n�yeA�be����batenr►er��- ' - _ -
<br /> Federal-Avlatton�Authortty�Runwa"ys:°' -
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<br /> I understand.that.the::folfovu�ng:�restct�tlons�pply t'm the use of flii:
<br /> � - Use offill is not alfowed iniFtoad�Zone"V"uMe�s expcessiy permitted.
<br /> • If the=.:fi11 maCer�a1�`�isAto''tie usedw ii��:Fbod�Zone. "A", it�is unde�stood that�a drainage pdr�n addressing a _
<br /> "ccmpensating volume",wlll.be su�ml.tted at#�me of��permliting wlifch is prep�red by a professfanat engineet " ' -
<br /> Ilcen�ed.by'#he�tate�of"Flotld�: , � � � ° --,�,' :.� -
<br /> - If�h� flll��matertalY.ts to tie�used (n Fload 3one "A" tns connec�lon•wlth�a�per•mlNted b�llding using stem wal!_, ;,
<br /> � _ canstcuc#i,.o.,n,:.1-ce�ifyrth.�t�il��i�il:b.e�us�d onty.to flll the.area�wlthln�the�s#em�wall: � .
<br /> • if fli! `materiai�is�to tie�iged in��any are�;` i �certify �h+at .use. of-��uch flli wti) r�ot adversely atfect adJacent .
<br /> p�apettles,_.iF us��.of fill,ls:fopn�#to-advet��ly;,�ftect adJaeerit:';Prc�perNe��.the awr�er may be ctted far vlotating. -
<br /> the��condl�o�s�:of-lhe b�illd(�ig;pernilt�ls�ue��u�der tlie`��tEacliecl:_�ermlt�applk;atlon;:for.�fat�.less�#han"one �1)
<br /> acre wtilcti'aiae ele"vated'�tiy flll;,A��t:englneered dralnag�plan!s requlred. •� �
<br /> ff t am the�►GENT;�A1i�TM�=:0IMNER,;l�.p'r`or_'rtlse In gogd;_f,�lth ta Infarm�the�awner c�f�#he permltting cmndlt#ons set farth in
<br /> this atfidavit prfor fo icomrr�eracUg canstructton. "i undt�ratand that,,aKaeparate permlt may be requlred for elecMcal`.work, �- .
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<br /> plumbing,,signs. wetls,,:pools,�alt�.,c�ndit�oning;=:gas;,;or.atl3er'. instfill�t�ti�itis nat�sp�c�tcaily inclu�ied�in.the�application. .A. �
<br /> ermlt Issued �hall be canstr.ued to:be{'a'1lcense�toz '` '
<br /> P . . pr��e�d wlttal'ftia diiork�nd��nat-as:autharlty�to:vlolate;#c�ncet�-atfe�, ar
<br /> set aslde any�provlstons of ihe:tech'n[cal._cade�,,nor shall Issu�nce�af a.perpnit.pr.+�vent th�Bulldlrig O#�1cf�!from theceafter
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<br /> requlring�cocrection;af�errors�in-,ptens;4constractlon..oc.�lolatlans of•eny�ca�d�s:��very�p�emitt��ls�uerJ�'§tia!lrtiecome�lnv�lid
<br /> un�ess the work autitorizea:by such permtt:�s.commenced•withln,,si�c;,mon#hs bf�qermlt lssuance. or if work authorfxed by
<br /> the permit!s suspended•,cr:�bandaned.wfor-�a;period�of;sUcT:tB)�monffts;;after.the titne the�wo�iris commenced.. An extenslorn
<br /> may be requestedt-In.wrltln`9,:fram,#h�;Bulf ding,(3�iclat'for a perlod��not-io-exi�ee�'=nin�r�r�(8�)=iiays e�d�will�d�monstr�te
<br /> Justlfiable'cause tor�lhe extenslon. If wor.k cea�ses.for nlne�y.(9Q�aons.ecutive�day.s,..the�ob�ls cansidered aba�daned. �
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<br /> VFlARNING TO OWN�R: YOUR..FAIUJRErTO.,:R�EC.O�tQ:A;NQT�IGE:BF�.�CQMM6i�QEMEI�T,NFAY�.RE�WLT�IN�YCbUR "
<br /> PAYINt�'i"WICE:�OFt=�Ml�ttoVEM��N���T����Ui�:P�RER�TY:>°1�=:YOU;i�D:�To���i8�1�1N�giNi�1�EN�C�;�CONstI�T
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<br /> 3ubscxlbed and awam (or alflrmed)betore m la Sub�cxibed end'swq�a:b(o�afflnned� �tora rtte " '
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<br /> Wholsfarepersonally.kttowt�to.me.or:heslhaxq.prc�c#uced Who:fslare.,p.e on&liy�cn�um�_ ;tn�sor_iiealharre-pnsdi�ced- �-
<br /> ��Id`en8flcatlOn: . as ld�ntlflcaBan. �
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<br /> Mat�ry Pnbftc . Notary Publlc
<br /> Commtsaton No;4 Comt� alo �Ma, ,,,�°����•� UE IN OCES
<br /> :'�� '';«: Commission
<br /> - ��_ ' s December 12,2Q18
<br /> Name oi Notery fyped,p►inted or atamped Nelrie OP Nplery lyp6 � �9�p1�Troy F�in Insurence
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