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<br /> idOTIC�Q�DE�D RE�TRI�TlONS: The undersigned under#tands;:th�.thls:p�rmiE may.b�,subJect_to"deed"restrictlans" -
<br /> which may be��rnore�r.esttictNe.than Cou�ly regt�afattong:`THe und�rslgned�ssurries�sresp�insibitity far camptiance with any
<br /> applicable deed reshlcftons. _. -: . � •
<br /> l��tlCEMSED Gt3t�TRJ���`OR� J�ND-C�N�'R�l�'������i�AN�1i���:tT1��: 1� th� �wner h�s �hiced �a� cont�actor or
<br /> contractars to ut�dertake v�ork�th�y m�t:be:cequtr:ed;.to:be;it�ensed In�cccxrda�c,�.wlth state,and•loca!tegulatlons. !f the
<br /> contractoc #s not ilcens�d as requlred�by lav�r. 5�th the awnac�ind.co�t�actormay�be�aite�d fmr a�migd.emeanor violatlon
<br /> und�r state law. !f the owner or Intended=contra�tcr�are�uncerteitre �s to wha�t licenaing.�quiremants may appty�f6r the
<br /> Intended work� they are advlsed to cairitact the Pa�ca County�ultding tnspection D�vision-�-�:icensing Sectton at 72fi-847-
<br /> 8009. �u�thermore, if the �owner ha�s h1�d a contt�acfor�oT contractars, h�i 1s advtsed to have ths contractor{s) slgn
<br /> portion� �f fhe�°cont�cEar.�loc�" o��9�Es.�pticatlon�ar r�hlch ttaey v�lll,be.tespcn�lble. ff you,-as.the owner stgn'as fhe �.
<br /> �ontra�ctor, 4h�t�map be an Indicatlon�that fie�1s not properly Ilcensed and°1s not entltled hs permitting pri�lleges fn Pasca�
<br /> County. �
<br /> �'RA6����RT�#"T1C1N�IIdI�d�CTIl�TILI'I�E�`i�IP�l61=-Ai�(���E�A�1�tCi��EC��EtY�=EE�: T�te under�igned ianderstands
<br /> �at Transportatlon Impact Fees.a�td.Recour�e R+�ca�e.ry.Feas may�;apply to:the.canshuction of newr_buildtngs,:c#iatage 6��.
<br /> use in existing.buifdings� or�expansld����eiiis#t�%g<6u3ldings, as�pectfled-In P�sco Count�r C?rdlnance number 89-07 and
<br /> �0-07, �s s,mended. '�he undetsigned also:understands; Qhat�such fees,�.as��ay_be�:due;.�will.be identffied at the time of�
<br /> �ecmit��tg. 1k is further aand��tood th�k Tra�sport�tian lmp�ct���s and itesource Recoverji=Fees.must be paid prior to
<br /> ��ce��ing�°certlflcate of�occupa�cy" or�fln�l pmwer=��lease. �€the proj�ct�does not invoive.a�°c�rtffic�t� +�f occupancy..or�� �
<br /> fn�l power rele�se; the fees mn�#b� patd prtor#o p�rmft issuance. F��thermare;i�.Past���ouniy_1NaterlSewer impaat
<br /> fees are due,th�y.must be-pafd.prior�o permit��issuarice•in accordance witl��applic�tbte.Pasca Cour�ty orcllnanc�s. -
<br /> ��JM��'R��Ti�fid L4l�N 1L14�M{Cf���t��T13,�I�r�����tui�����n�ttd�td�: If�talua�on of virark is$2,5U0.00 or more.l ..
<br /> ���tify �h�t 1� #he �pplicant, hsue-been p�avtded wlth a capy�of�the��Flo�ida• Canstructton� Lteri .l.aw--Homeawnec's
<br /> �rotec4bn Gulde° prepared by the�lorlda QeparEment�of Agrlculture and Cons�mer�Affairs. If the appl(cant is someon�
<br /> �@hee 9han the�o�mer", I certffy fhat.l�have.ob4ain�d�.a c�opy.of..th�:abode..r�e�scrlb�ddocu�ent=and.ptomis+�in,goad:fai�h ta
<br /> deliv�r It to the`ovimec"�prior to�cammencement. ' � .
<br /> ���T�6T9R'�/A1�IME�'��6FE�i�fd�VliT: 1 ceifity;.ftiat ait�th�►.{niformati�n i�t this applEcatton is accurate.and that ali v�ark �
<br /> wi0i'be done i�t complianc��rith ail.appllcable laws regul�t�t�g r.�nstructton. aontng and;�l�ntf�develapment. App![catl�n is
<br /> �er�by �nade to �btaln .a.permit to do�_wofk:and tnsta!latlon �s �ndt�afed�� :I. certlty that no work `or tnstallatton has �
<br /> commencad prlor to lssu�nce of a pernnit"and that.al! work will b� performed�to meet standards of all laws regula�ing-
<br /> �a��struction, County and Clty codes, xoNng regulatiQns, �nd land dQve�lopment r.egulattons�tn the juri�dictian. 1 alsa
<br /> cer�i�that I u�derstand th�t fhe regutaftons of ofher�gaverrom�nt�g�nal�s may•appty#o the intended work� and that it i�
<br /> my r�sponsibiiity to idenHfy•wh�t.�aiions i mus#�tak�:tu b��in�ca��ipliance 5uch agenci�s lnalude but are.na#limtted to:
<br /> - Department of E►1vlronment�l Pratectton-G'y�res�.�8ayh�ad�; !l�e�and Areas a�nd Enuironment�lly Sensitive
<br /> Lands�V�aQertW�stswat�r Tt�atmer�t.
<br /> - Sou#hwest Florida Wa�ter [Vlanagem�nt:�istrict-Wells, Cypr��.Y Bay.heads; WeQand E4reas. Altering
<br /> � vVaterr�:�ours�s.
<br /> - Armb Corps of Engtneer.��eawatis�Docks,�1�vlg�tite Waterways.
<br /> - D+spar#m�nt of Health�:&, R�E�abiiit�tive ��ntt�esl��tv��onttne�ttat He�fth llit#t!lN�elf.s, Waste�aQer Tre�trr��nt,
<br /> Septia Tarik�. � � _
<br /> - US Envlronmentai Protec�lon Age�cy-A�bes�t�s ab�tem�nQ.._
<br /> F�dera!Aviatton�Authority-Rur�ways.
<br /> I und�rstand that Qhe following.�resiMc�ions appty to the us�of flll:
<br /> - Us�af�il is no#atlowed in Fload�Zone"V"�nfess expressly permitted.
<br /> - If fihe �li m�i#arlat is ta be u�ed.in..ftood Zan�. °A". tt. Es und�rstaod #hat a dralnage plan �ddressEng a
<br /> °compe�sating vclusn�°wil! ba submltt�d aQ#Ime �g p�rrnitting�rliich 1� prepared by � professfona! �nglneer
<br /> ltcens�ed by�he State af Flo�ida; � �
<br /> - !f ihe flll material:is�to be used In Flood �one °A° It�-�conn�c�ion�with:a�per•mitted buitding using sfem wall
<br /> � construction, i certif�th.at fiil.�atl:b.e�sed only.to.fiili the-ar�a wi#hin�the�s#em•wati.
<br /> - If fill mateNal is t� be used in any area� 1�certify fhat .use of such fiti wtll nat adversely afi�ct adjacent
<br /> � p�operties. If use of 9i14 is foc�nd to advers�ly:�ffecf ad�a�ant�propertl�s..the avuner may be cited for u!a[ating
<br /> �he cor�d�ions of the b�iiding.per+mlt Issued�under th��k�aatied}�ermtt app(�catlan, for Jots less than.one{1)
<br /> �cre w4�tch�e�Revated-by f�ll;a�t engineer�ed drain�ge plan i���qutred. •�
<br /> 9g!am 4he�GlEP1T FOR TH�OWMt�R� I�.�romtse!n good f.alth ta�Infor�the o�rner of fhe perniitttng candftions set forth in
<br /> �his affidaeft�prtor to comm�ncing cons#ruction. fi unde�rstand#hat�a��eparate permif may be r�quired for etecMcal wark,
<br /> �turvrbing, signs, wefts�.Poais,, air conditiaNng�.gas� or a#�ier: insfall�tions no�.spe��ftcal�jr tnsfudsd-in.the applfcation. :A
<br /> �ere�nit tssued sitaE! be construed ta b�a�ltcense°to proceed�ith ttie wark and not as.�ukhorliy to.vlolater canaal.alter, o�
<br /> s�t�slde an�pr��islons of!�e t�chnlca)cod�s;�nor shall lssu�nce�of a.permt#.pr�vent the�ultdirig Offtcia)from thereafter
<br /> Pequlring�coRectior�af errors in.pl�r�s; constructlon or vtolatlons of any codes. Every�p�rmlt issued shall�became irn�aiid
<br /> unles� the�rork authorized:by such p�rmtf:�is��ornmenced�wi@h6n si� months of�petmlt i�sus,nce�, or if avark autharized by
<br /> �t�e p�rmi#is s�aspendad�or.abandoned�for a:period af=siac-{�)�monff�s.sfter_t�i�tirtte.thev�ork�is commencsd. An extens[a�
<br /> �ay be requ�sted. ln v�riting,from#he'B�Itding,t��iclal for a pert�d�not-#o e�cceed n[r�ety�(90j.days a�d will demonstr�te
<br /> . justi��bte cause for_�t4�e extenslon: 4fi wa�rk c�as�s:f�r nirtet��90)cons.ecutive.day.s�.t�ie�gb�is considered aba�doRed.
<br /> �N�I�7dlf�� '�'� OI�MER: X�UR_FAILURE-T�aRECOltQ A.(�ATIGI� OF•�AMMEMCEMEI�T�NtAY•RES�ILT IN�1ttJUR
<br /> ��V1�4C`�Mf�E l�OR�IMPROVEMEI1tTS T�O a(�Ut�;PRDPEi�TY. i�°Yd�1�1�M�'t1B:TA��B�T;AlA1�PiNAt�EiNG;�t�NSULT
<br /> ��� Y �A i� D �A. r�R� �R�1 F�. ' .�-E�O fu�� �l3� :. : ,�� .tlF �� � E C �
<br /> Fi.Ofd{DA JUFtA�(P.S:t'lx.�3} . . . . . � ..
<br /> OWN�R Q�A�t3EPtT CCiMTRlIGTt) �
<br /> Subsaibed and swom!o(or a�lrtned}befare me thls Stib r,rlb��d�snd'swo�(}r afftrmed)�befo�e me�ttii
<br /> bY ' ��'11L_'bY ll S?0 Cr_°�. �/ti1
<br /> Who islare personafly lmawn ta.me ar ha�ve prqduced W�o.ts/are p.ets atiy �ta.me or hasfiave-pr�cd'c d +
<br /> ae idendflce8pn. A�,t�'(,�, ,�,�!�� as IdenBficaUon.
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<br /> Rlotery Pubpc . fh?� L�.�1L.�. ,��. tVofary Pabltc
<br /> Cammiaslan No-: mnt�Is�lon.Plo. ?
<br /> a��� � '
<br /> tdame ot Notary typed,ptinted or stamped Name oY f�olary typed,ptinted or stamped
<br /> �
<br /> �1;��^�'••. DEBRAELAINERUFFELL
<br /> :;�' �';�Commission#GG 045343
<br /> :;��,;��,;o:Expires November 7,2020
<br /> • %;OF f��P`�, 9aided Thtu Iroy fainlns�rance 80a385�1018
<br /> .. �+etlN
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