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<br /> Mi�T#CE 9F�DlEED RES:T.RIC7tQ�S: The.under�lgned:unde�tands�th�t;a#hls�;��rt��t�nay°be�.subfe„c,t;,.to;�deed";restr�c#Iorts�TM�,�._,�;.;,w-�
<br /> � ' "' F. .":Gr-. ,.rt- �„ ... . r„�t-..y. z� ..�. .�.3.e•..y,��?Ca"-�. ..7_;' .;c' a A ' i k�7..<',�iK.n"hxs..a;.w.a.��x
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<br /> which majr�'tie�=mare.;"r:'�stt�ottve�tfi���Corin.ly�ii`�g�l�t�cng`s�'°The^underslgned��a��urri�s'�responslbilfty�far"compilance with�eny.
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<br /> appUceble�desd=res#cictlons. �.,. .:� . �: i� � .. _ _ . _.�� ...,-, .-
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<br /> UNl.tCENS'ED�.;CONTf�ACTCiRS�:ANb CtlN�►C'��R-ltE�PON�18l�1lT�i�S:=.}tf�t�te�rtiwner��h�s�:;iiii�d`""a�`.�riti�actar or
<br /> contra�actors.to undertake work,�:ttiey may.:bs,.c�iqerlred�to;At���llcensed�in;accordance 4with;state.ands Inaal�;cegulations:��If�the�;.=�.g.,,����a
<br /> �:�r�. it"s.':�'«-n�W.i- k
<br /> contractor.�lsrr�ot�1lcenseif�=as=�%eqi�ilrod'Eijr'-fi�w,�tiotfiT��lie �er amf��atrati==tor{�may�ber�clted��for�a`mi�'cleiiieanc�r vlola#lon �
<br /> under state taw. If the awner.ar Intended�j�ontr�i!�to�:are;;unc��tain.as=to,uvhat Ilcensing;requireKn�n#s��rriey��appijr��ir;��!'tiie"�-vr�=�s�=���
<br /> intended woi�k��_tFl@ ��A adYIS@LI"t6"ca`°ntact`ttie:P"asco±County 8ulldl�i�Flnspei:tlon�Dhtxl�ion-�.icensJng Sectlon at.727-847-
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<br /> 8009. �ur#tiermare, if #he awner`tias"'htn����coinUactoT"oT coriti�ctors� he is ad`vtsed to hav�;:the contrsctor(s},.sign�. . I
<br /> � I ilceti nafor.whlch.:the will•be�.r.es oasible- It: ��"���"�"#`�' '4.�''.��'� �"'��'��'::��v
<br /> ponians�of the,-�.contr,acta�..Black":.of,th e,;ap�p .!� , Y- . P .�•- You;�as�:the owne�r's��n�''as�th�'w
<br /> contraotor;#hat•rriay�b� an indir.��on tliet'�ie�-is"nait:piope�y`Itcensed"anil�''1"s riof"e��ed'fia�permlt#ing�pFiixll'ege� tn'Pasca:�;� ,. �
<br /> COUII�. , :, ' ' 4 �,�,� aw'_�: .�'�
<br /> TR�►MSPORTAT�pN-lMPACTIUTIL�t'IES=I�P�C'�'�=ANb RE�AU1tCE RE�:qYERV f EES:�'T�1e�u�itletsl�riei�`understartds
<br /> that Transpartatian Impact Fee�s:andrvReco.urse Recavery:Fees,may;apply<�to�ti�e..construction.,of nev�►buildfngs,ichan�e��of:��r�'„�=���n�
<br /> use In.existingAbufldings;{�i�r,�expangl�rr of�e�ias�iM�,buildings, as speciited.ln Pesco Cvunty Ordinance number 89-07 �nd_
<br /> 90-OT, as arr�end�rd.*_T.i;�re� undersigned also;�understatids; tFia�#:�siich fees;n��sm$jt;��.due;Y��iiFrbe.I�eri�ifiad a##hs�ti�i±��-_���:�fl���'.�`
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<br /> permilting. It Is iui�ther understood that Tra�sp��ortation Impact'Fees artct`•-Resouraa.:Re�c'o3e'ry��Fees�.mu�t be pald priar to
<br /> recei�ing:a'ce�ittcate�af=occupa�cy"i.or�f�nei,power.�tease:�.,�1fit_h�.proj�,��ld�es�:'rt'�invotve�a�certiftc,ate of accttpancyhoc��'�'4,�.�-�
<br /> final poviiec�retea�e;��iiierfees-riiu9it�'bie paid��p�ior#o,;,pecmft lssivaiice. F��the„rmore;::i��Fascc,��Gount�"VkiaterlSewer:impact;=;�$���•:�
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<br /> fees are due;,they:mustbe;:pald;pttoc,�a�;.permitsls.s.tlence;�n.accoiilance w1tFr:appllcatite.�Pasco�County��oiiltnances. •
<br /> COWSTRUC"�ON'i:IEN t.J�Y11�Ch�pter T73�Elor�c@s�t�t�#���as arn�rrd�tl}: Ifi vatuallon of work i��2,SOO.OQ�or.�more;:;l��:�° <;��=;
<br /> cerlify tFiat��.l, �he:;applicent;_;have:;be.en__prvvideif ,wlth a=copy°�.of��tt�er�"�lo�ida��'Gor'istructiort`�-Lten-:Law--Homec�wrter's
<br /> Protection Gutde"prepatted by'tlie Ft��ida Depart�me�t;of Agrtcultt�re and C�nsr�,m�r,;,Affah�."s. If the eppltcant Is,sameo��;.,�..:;-.:•--;�
<br /> other than ihe'owner", I certifj;+,_.th�t l,h�ve;��t�ineitl�'a��copy.of..#be�;abQve:riescrlbed:�loaii�ent��ad: t�i�i�ii�e`;Iri; 'ood:�faith�to�.. .t., °;�w
<br /> de!(ver It to.�,lCis�"ov+iriei�`p'rioi-�fawcorn -�. �'`', � - ; �� � ., � . �., , . - °p g . -
<br /> mencement; .-..'. ., :,;.,.: ,.:�.. . .,: �.,�,.r. �-. , . . �.. ,
<br /> �ONTRACT�R'��4WNER'�aFFIDAViT: 1.cert,�y,#Fi�#:�.ali:�the��ir�tormatlo»iJ��thi�sppllcatton is accurat�.�nd thatall�wark
<br /> will'be done in compliance with all.applicable lav�s.�egulating c�nstructlon, zonin�g antl:�land�'tlevelopm�nt. Appltcation is
<br /> hereby made-.,#o;obt�lii;:`a permt#,;�te�;doa±n�o��;and:=ftf;i_"s:#allat�on es 1ndl�etetl:�-�=>I>ceitiity that no work�ar Instalt�tton�t�ais:,
<br /> commenced prio� to tssuance of.a p�armit'"and that":all��rork wlli be pertormed�to meet:standards�af-all lav�►s�regulating�
<br /> corasbuctbn, Goun t�t !9 9 P �9 � . .� �`.
<br /> !y and C� codes,.zonln re ulatians, and land dev�ta mer�t .-::`"utat�ons�1n-fhe�'rlsdlc#1ori:}�`!'�al'so= .
<br /> certiiy that 1 u�der�tand that the PeguMatlons of other�government agencies may�apply_;#a.the:.intended.:work� and that tt Is .
<br /> my responslbll(ty ta identity-•what,acttons l;must�take�to.be,;ln�oorrfp!lance:T;Sit�h;age�cfes�lnclude bu#=are;not fimited to: � -�� -
<br /> 4 �•'s,�b;`�.^.���.{.f2x.� X�:37�.f.. : � <�1 h i .<+.��3i.t:i
<br /> - Depactimen# af E�vironmenta!'>Protectian`-Gypr���."BayFiead�, V�e�end Areas and Enyironmentatiy Sensitive
<br /> I.ands,WateNWaslewater Treatmen#. ', ' �'` . - � :.
<br /> - Saut#fuvest Ftar�da W�ter Mettsgem+ari��'�:'�Isb,lct..Wet1's;'`3:t;ypt�ess.�8ey#�eail�;- 'Wetland' Areas, Altering
<br /> �8t@I'COl1fS@$. '»r.: �,-':?- _.�t .:.;j,,;ry'.t�,'. • . , .. .. ,. , _.
<br /> - Army Corps of Engtneei`s�e�walls��Docks,Mavlgatit��Wetetways. , , . -
<br /> - Department:..of�,Nealfh�;t&,.:;Re�aab�litative�,Settiices/Envitonmental;.Hea1#h�Unit=tiVetlsi�VlFaste�ait�r2•Tre�trnent; - '
<br /> Septic`T�nksi,:. .3'1 J'�t. '_.. u, . .. .. ' _ ... + .
<br /> - US Envlronmental�Protec#1on A�encyAsbesto��bateme»t. _
<br /> �Federal A.vlat�on::Authv,yiy.r:�Runuvays:� ; � � � `
<br /> 1 understand 1hat.tt�e:followirig;�res�trictlons appiy fo ttie usa af flll:•
<br /> - Use of flti is not ailowed iniFiooc�xZone'°1�uniess express{y permitted.
<br /> - if tlie.zfllf'me#ei�lal�-ls��to��b.e �usetl�In.:flood 2one. "A", 1� is understood tfiat�a dratnage plan addressing a
<br /> "compensating volume"will be subr�ritted a##ime af�permitting wtxfich is pr�pered by a professtona! engineer- � �
<br /> Ooensed_tiy'#fie;:�tate of'FMotida: �� °�� -
<br /> - . !f th��flll meterta`rl;ts-�to-bea.used In Ftood �one `A° in�connec�Eon�wlth�a��ermitted b�llding using s#em wall,,, .,
<br /> constnua#ion,�I.certify;th.at�,flil:vVail:b.e�used only.to fiil#h�area•within�the•skem��wall: ,
<br /> - If flA matenal'Is��to'pe` used-9n.any .+ar+�a; ! �certfty��hat ,usa oE,such flll will not adversesy at�ect adJacent _ .,
<br /> properties.:_.iF use;;of.fill�ts.�#ot�ncFrto-advers.�sfy:..��ct..aafac�r�t��pc�pe�tie��.#he owner may be`ci#ed for a�i�tating. -
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<br /> the cond�fons.�of�the bulldiu�g'perrriit i�s�ed�under tlte"sitt�cFied��pecmit�applicatlan,�for�:lots:less ttian:`one (4)
<br /> acre vutiliati.gre elevateii�tiy.�1tl;,,��t-engineer�ed dr��nag�plan is required, � .. .
<br /> If I am the AGENT�,FOR;,TM��.OIMNER;;I;promise:.ln:.good,:f.alth,to Inform'#he�ownec.of�thia permitting condRtans set forth In
<br /> thts affidavit"prior fo comit�eiacing constrt�otlon. �1 uri�erstarid that azseparate�permlt may be tequired for etecMcal.work. • . .
<br /> ptumbing,.s�gns, wells,,.poofsi.alr conditianing;.gas;�;ar othe� insfall�i�;ns no��spec�ficaliy inciuded�in.fhe�apptica#ion. .A -
<br /> permit Issue�°"shall be coiishued to'�be;�a'Iicens�`to><proceed vvith�tFie.;,.viro�k and`.•not�as:authoHty�:to;vialate;�'cancel�-alter, ar
<br /> set aside'any�pravtsfons of t�ie:tecli�tc�tl c�des;,nor shati is�u�nce�af a.permlt.prevent t�e 8ulldlrig{?�fic�al from thereafter �
<br /> requirtn,g a_coc�ectian;af.,errors,in>pl�ans,.�constiuctlon.or.violatlons of�any�codes:�.�very�p�armlt"�I.ssu�d��stialf-tiecoine�invalld
<br /> unless the work authortzea.by�uch permlt:�ts.cosnmenEed�wlthln sf�c,,months of�permlt fssuance, or#wcrk aufhnrized by �
<br /> #he permit is�suspended:cr�:abar�doned�for:a;period;of�six+�f6)�monttis�:aRer:the:tinae the�wor�ri�commenced.. An entensian-
<br /> may be requested,�in.w�i#In`g;,ir`om:tfie�Building,Offl�lal�for a perlod.,not.to exceed"nfn�t��(90)��ajis ei�d4w111~demonstrs�te
<br /> Just�f�bl�'causs for:�#he�ckenslon. tf wor[c ceas�.for nlnety.{90j cons.ecutive:d�y.s,..the�ab�1s.considered aba�doned.
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<br /> WAItNtNG TO 4VYNER; YO,UR.;�Ail.t�lRE;;Tta..;R�E.CQ�tE�.�A��G�;lCE�:O��•�COMM�M��ME�T�,lIItAYxRESUE:T�iN�YUUR �
<br /> PAYiNt3 TWICE;FOR�IMPRO�'/EMEN7`S�TO;Y�Ui:��PR��ER�;7Y:��I�-:YO.U�I�V'�'�E�VI'�TTE�`�f5H7%AIN�F1NAp�IN�;,�Ow5UL7
<br /> WIT D N� O FO. t, ��� :,, . � ; :�d ..� .> .
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<br /> OIMNER OR AO�NT , - � GCyM'RAR:TOR �-rJ�n�( � r�w.�—�.- '
<br /> Snbscrib�and swom ta{or�flfrrr�ed)betore me#hts Stibscrfbad and'swom�p{ot aflir�» rttb tti€�� ,
<br /> by ' ��by....(/c�heL;�( ����,�'�,ti
<br /> lo�re personaliy.knovm to.me.or.:heslhave,produced , � ts/�re p.ersonally.�Cnammm�to�ma-.or#iaalhave��troduced. •.. ,
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<br /> ae I�aiidRi�f1�». _ ' ; _ C� c�rzc .,-s Crcnn� as Iden8Rca8an.
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<br /> No�ry Pubitc ' tary Public
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<br /> Commisstan No;` � Com� s1 •hta 84��5
<br /> ' :���'����`�'': Commission#FF 2 8
<br /> �*= ber 12, 01
<br /> tdame of Notaey typed,Printed or atamped Name of Natery typed, o n,�T,���t�+�C°
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