- � - �
<br /> n a ' '',n ^ '�:"�'•-
<br /> � T �u e�i n�d nd�rgtands�:Q��t�thB�- rrnit�:m� .be,sub�ct to d�e o
<br /> R90Y�CE OF DEED RES'P93oCTE0��.,., h .. _�d�..-9.:,•:,: :°� . ..;. .;:-�:r�.--.��.,.'�:.-,•.<��:���.:::::;r.w�4t�.y;.:,:w.-M :s_1J�...:;R::;�4.,...:.:,d,;restpBcH.,.:�5:.:.:-,..- W� �
<br /> which may�be>moro`.rest��ctive�4l�a��Co[�nty�r��ul�tlons°:'Q'he��undee�lgne.d���ssumes'r�aponsiblllty.�.for�compli�nCe�wdth'�ny �
<br /> �pp0lcable deed r��t�ictions. � . _ � ��
<br /> �JN�.ICE�ISED°CONTI�►CYAf�S m�1D CON!°a'�tAC1'O����SPONSIBLf�:ITI�S: If�•the �uvner h�s�°h3r�d���`,contr�etar or �
<br /> cor�tractors to undertake work, 4h�y may:be:,r�lqteiretl.+to::be-��icenaed In.ac�rdance.HrOth�state:and�loc�l:regulatl.ons:.;^if�th��� -- I
<br /> �onQracto� ls not lic�nsed ���requl�d=tiy law, both �the oa�er and'�cont�actora-ii�ay�be�-clted�for�a nnlsdeme�nor vtolatton
<br /> und�r state I�w. oP 4he own�r or intend�d;;c�„n,trac�or,1�re;uncertaln as Qo�nrh�t ItcensOn,g;requirements smayl�epp0y��✓foc-the� � -
<br /> intended work,they�re advl��d to cotitact tFi�.Pasco GounQ�+�ullding�In�p�ctfon.Dfvlslon--Ltc�nsing Section et 727-847-
<br /> 800�. Furthermore, If the owrner lia�'hiPed'� eontrecfor o� contr�ctor�� he i� �dvl�ed to have �th� contr�ctor(s)„sQgn:. ,,
<br /> „r. _.,,_.
<br /> portlons of th� "contractor Block� of Rhla,��ppllcation..for_which they,will.b�..r.esp.o�rsible.� :If-you,:as:�#he ovinie�'sign'�'e�''th�" ``
<br /> contractor, th�@�m�r be an IndicatEon th�t'iie 1s noQ:properly 11cen��d`a�tl"is�not entitled Qo perrriit�ing pri�lleges In Pasco
<br /> County. . : : :. .
<br /> �'�I��PORT!lTION-IMtaACTOUTILIT`IE5=1�IP�C'I�AR1�-I�E�OUltC�RE�OV�RY�FEES: T"he undersigned u�der�tands
<br /> ehat Teansportallo� Impact Fee��and.Recout�e.Recov�ry.Fees m�y:�ppVy4�to�the_conaQndctlon�of new..bulldtngs.,�ch�nge��of�=` °�+`� '°
<br /> u�e In exis8ng bulldings, or;�xpar�'sior�rrof=}exi�ti�%gYbuilding�, as specifled.tn Pasco County O�din�nce number 89-07 �nd
<br /> 90-07, as �rrrended.�:The und��igned �I�o:�underst�c�ds; Q7��t:�su�fee�;�;as tmay_tie�=dtae;,:wili;�e Id�ritifl�d a4 th��tiQi�ie�of>'" '�� '
<br /> permi�4ing. It is fur�her und�rstood @h�t Tra�sp'o�tatio� Innpact Fee� �ndaR��ource.;Ftecovery=Fe�s�,mu'st be paid prior to I
<br /> receiding-�:'c�rtificate=of�occupancy" or fln�i-�.power;rele��e: :!f Ehe.proJ�ct:does�.not involv���;�cert6ficafe og occupancy.�o�E'�':i� '
<br /> fln�! power�r�lea�e;�the°:f�es�mu�t be petd.pclor to,pecmit i�suance. F��thermore;��if.Pasc�;�C�unty��Water/Sewer•�Impact � � -
<br /> i.1.
<br /> f�es are due,..they.:must..be�p�ld:pilor to.p..�rmlt�.I��u�iRac��ir�.�ccordance�rlt��appllcatil�Pasco'�.Coun�i�oetllnans�s. � '
<br /> ��P9STRUC7'@OP9 LI�N'l.A�l(�Oi�pt�r 713� �lorlda�t�tut���as atn�nd�d): If valuatlon of�rork Is�2,500.00.:or mor�,.1- -�
<br /> ce�ti� 4h�t I, #he. appllcent,-h�v.e.been .provld�d-�wdth. a �py of the �°F9oPida� Constructton� Uen._L'�v�—l-lomeowne�'s
<br /> Pro@�ction Guide" pr�p�r�d by the FloPlda Department�of'Agrlc.ultur� and Consumge;Aff�ar�. If the �ppllcanQ Is someoroe .
<br /> oth�P than the"owne�", I ceetlfy,th�t I.have.obteilned=a=copy,of:#he�above..rlescrlbe:d��docurr��nt°and:pro�olse�,:ln;good',,�Ith.to
<br /> delib�r It to.the°,o�rne�"�pi�or.•'to��mmerticeine�Q:'
<br /> CONTRACTOR'S/OVI9NER'�I�FIDAVIT: L cePtffy:�:tt�i��t;all.th�,lnf.orm�ti�n.:in�thls�pplfcatlon is accurate.�nd fhat�II work
<br /> will'be done in comp0fance with �II.appllca�bie��vus regulatDng corostrucfilon, aon9rag and��la,nd°deereloprreent. AppltcatBon fs
<br /> h�r�by made .to obtaln .� peemit;:to do�-mraor,k:�and Onstell��lon �s 1ndlC�te.d:-=.-:I c�rtify that no wark�:or Installat{on has
<br /> comm�nced ��lor �o Issuatace of�� p�rmiQ"and Bhat�:�10 wor@c wlll �e p�o�med to me�t_�t�ndard�-of �II lav►�s regul��ing�
<br /> �ns4�ucelon, County and City cod�s, zoning regulatian�, and land d�velopment r�gulations`tn the jurlsdlctlon: I al'so
<br /> certBfy th�t I u�d�rstand that the r�gulations oi oQher gov�rnment�g�ncl�s may�apply�to the Int�nded�vork, and that it ls
<br /> my responslbllily Qo Id�nti�y•wh�t,act(ons I mu�t•t�k�:to be�ln:.co�lpllance,.S�ach.ag�ncle�lrrclud�but��are.root Ilnoited to:
<br /> - Depae�Roent of Erlvtronmental'P'otecfton'=Gypre�s.`Bayh'�ad�, WeHend Are�s and Envlronrnentally Sensitive
<br /> L�nd�,liil�terM/ast�vdater Tre�ttrv�ent. �
<br /> - South��s@ Florlda 1Nater lWan�gement: .Dlstrlct Wells, Cypress.'���y�te�ds; W�tBand /�re�s, Altering
<br /> VNaYercourses.
<br /> I - Arany C�rps of Englneees-Seauvel9�, Docks, i�avE�able VVaterv�rays.
<br /> - Dep�rtment of.Flealth;'.� Retj�blHtativ��.Servfce�lE�viro�ment�l H�alth Unit-W�IIs,�11Va��ewraQer�Tre�tcnent,
<br /> Septic l'antc�. �
<br /> 0 US Env(ronmenQ�l Prot�ctlon Ag�ncy-Asbestos�b�tement. �
<br /> F'ed�r�E Avlativn:Autho�9ty=Runwey�.
<br /> I undersQand that the fol9owarag:-restrlctions apply t�the use of flll:•
<br /> - Use of flll Is not allowed In:Flood,Zone"�f"unle���xpr�ssly p�e�lQted.
<br /> - If the fil9 materi�l Is •to b.� used: In.�Flood Zone. "A", tt I� un��rstood that a dralnag� plan addr�ssing a
<br /> "compensating volume"will be �ubmltted at tim� o�tp�r�ni�ttng whfch Is prep�red by a pro��ssional englneer
<br /> n
<br /> Ileen�ed bythe S4�te of�Flotlda.
<br /> - If ih� flll materlal�t� to be us�d In Flood �bne 'A" Ins coran�c�lon��►Ith�� permitt�d bntlding using stem wall
<br /> . consQn�cQfon, I certify that flil:v�Jil=b.�used only.to.fill the are�inrlthln�the�stem�nraBl.
<br /> � If flll m�teelal Os to be used ln s�ny are�, I certOfy t#�e�t .use. of`such flll w111 not adv�r��ly �ff�ct adjacent
<br /> prope�les. If use of flll Is foc�nd�to �dv..�rs�Py:�f�ect ad)�E�nt�propertl��.th�owner rnay be'clted for violating
<br /> the condl�(ons.,of the bullding;permlQ Is`sued�und�r @he attached,�rmit �pplicaQlon, for:lots�less lhan one (1 j
<br /> acre whtch ar�elev�ted�by flll, �n englneer•�d dr�ln�g�plan I�requlred.
<br /> If I arra the AGEfdT.FOOt�WE-0Y�1WEf3, I;.pro�Ese In good falth to Ic�forrn th��owr��r of�the perenitting coradltlons set forth In
<br /> Qhis a�davit`prlor Qo commeneing constructlon. "I unde�t�nd that�-separate perrnit may be requtr�d for electrlc�l�work�
<br /> -�.._�.
<br /> plumbtng, signs, wrells,.pools;, alr coe�diBoningp..gas, .or ott��� In�tall�tlons not,speclflca6ly Included-Ire.the�application. .A
<br /> perrtrelQ Issu�d shalE be constcu�d Qo b`e a�It�ens�'to=prnceed e�rlth th�v�rk�nd not-a�.��athorlty:to..vlol�@e,.cane�l, �Iter, or
<br /> set asld��ny provd�lons of�he Q�chnle�9.c+od�s;�nor sFo�ll issu�nce�of a.perrnit.prevent th�a�ulldlrig O�Icl�l from ther�after
<br /> requirin.g�conectlon nf erro�s In��plans;-oon�t�ct0on.or vlolatlons of-any cod�a. Every��p�erinit•�Isaued stis�ll�becoen�indalid
<br /> unless the work auehor6z�d.by sttch perrnit>�Is-comm�nc�d•wlthln sUcmon4ha of permlt 0asuanc�, or !g�ork authorized by
<br /> the permit is suspend�d•or�.abae�doned-f,or:�.perlod,of slx:(�9j montf��.�Rer Qh�-tlme th��wo�k�Cs commenced. Ar9 ext�nslon
<br /> may b� r�qu�sted, tn writing;.from th�,��ullding,O�Icl�l for� p�rlod.�not-to �xc�ed°�niriety�(90)�days �nd valil demonstrate
<br /> just9fi�ble cause fot�4h�ext�n�lon•. If work ceas��:f�r nlneqr.Q9a)con��cutive day:��..th�)ob�ls.consldered abandoned.
<br /> HVA�NBMG �'O O1IVNER: YOIJ�_.�AILIJRE,•T�:,.R�ECQ�D A:,��TlGE:AF.�CO�A�AENC�IWEd�T.111�AY��ESt�LT IM �1�0l11�
<br /> F�A5I1118G TiRI10E,FQ�t�IMPROVER�9Eld7'S�.T�::Y�L•Dit:•.P�PE9&'Q�f: �I��Y�.Urs�l"�'F.�ID:��'���iDB7JAIN•=�INiAt��tNG;�ORI�UL,T
<br /> _R1v��H�m�9R LI�RI��R AI��!N A'�'�O�R1�x�,�Fe�R��I����SN����U�,�'�1�'�Y�F���A�III�iI�tdC���ENT' �_: _
<br /> FLORIDA JURA�:(F:S:9.17.03) . . . . _ . .. . _
<br /> OVV[�OER O�d Ati@NT ��---- �e�-•_._J COI�'�R14CTOR�6-�� �,�.�_1r.I, �
<br /> Sub c�b and�wom ar a�irtn ) efore me Is Subscrlbed'�nd'� m�o(ow aRlnned)'a�ooe me'tlii�
<br /> !� �y �y .by... .�,�,r �
<br /> �fI /J7/,Z- � aI�-�
<br /> � /, .� �/ Ti�/'/��
<br /> �bYP� Is/are ersonelly knowm.to.me or�Pras/have pro ucc�d liVho.l �re .er� iyknowm;t�me or hae/fs�ve•produced
<br /> 7�/S ,LC(��f..� �e Id'entlflcetl4n. _ G ��� //���-P. a�IdeneRcaeon.
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<br /> ,
<br /> � �i� / idotery Publlc . Notary Publlc
<br /> CommisslonNo: �� � � '� omr�l�slon•ido. �� ��s�
<br /> � � � ����� ���� ��e����
<br /> M me oP Notery typed,printed ar st ed , � �
<br /> ,•S;s1;.'�.,,, DEBRAELAINE:RUFFELL
<br /> ,•i�aX> DEBRA ELAINE RUFFELL ,o.•• sf,�
<br /> :��q• `�'• - =?' -Commission#Cz.,G a4.5343 .
<br /> i�'�, .=C.om�ryission#GG 045343 ,
<br /> � - � _ �• :�. 4 �=Expires Novem�:�x:2a�0
<br /> " •' _ ..;i���(;:�+mber 7.2020 _ ;;, ��„�;� �
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