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<br /> �lOTIG��l�DEE�RES"�l3E�TION�: The undersign�d und��t�nds=:tt��t.ttats;��rmi�may.b�.subJect_to"deed"restricHons"
<br /> whlch mey be<more�r.esthictive=thart Got�nty ragulat(on�:'The c�nderslgneii assumes respdnsibility for compliance with ariy -
<br /> appilcable d�ed resMctlans. ' , •
<br /> �J�II�t��NSED ��1MTR�CT�RS ��1� �At���"�� ���(���t�i���:Ci'1��: ff the autmer h�s�htred a�conEra�tor or
<br /> corttracfors ta undertake wark�#hey may:be.reiqulr�ecl=to��b�,l9censed In�ccardartce.vulth stats.and•local r�gulatlons. �If the-
<br /> co�tractar is not ltc�rtsed_as requtced°by lav�, both�the own�r and confcactor ms,y bg�clte�d for�a�-mtsdemeanor vi�laHon
<br /> under st�te lav�. !f the awner or Intended=contra�to��are•unaertaln as to what Itcensing.requirements may apptyfior-the
<br /> iMend�d workt#hey are advtsed to cantact the.Pasca Couniy�uttding tnspectlon Divistort---Ltcensing S�ction at T27-847
<br /> ��Og. Furtherrnore� ff #he ownee� h�s hired a �ontractor ���rit�actors� h�r i� �iivt��d ta have the ccn#r�ctor{s) sEgn
<br /> �artions af the "cantractar�fack°of t6�ls.appticatt�n t�or.v�hlah they witt,be.�resport�lbls. ff yau,.as.the owner stgn�as fhe ..
<br /> �o�Qr�ctoa�, 4hat�m�y b�an lr�rlica,�lora Qh�t�ti�a�is not.prgpe�ly lir.sn�ed and is not entitled ta p�arniitting pri�tileges !n Pasco
<br /> Counky. '
<br /> �'�M�P�63T�►'�ION I�IPI�CT/�lTill'�IES�tNIRAC"�AML1-6�E�AUiRCE���iV�RYfE�S; 'f�he undersigned understands
<br /> that Tr�nsparta�ion tmpact Feas�and.Recourse Recov�.ry.Fees may;apply#o:tfis canstructian ofi new buildings.�change of•
<br /> t�Se in eXistit7g bu1ldlTtgs� or expansl�r��o#:eiiis#i�i�=�illdings� as specifted-in Pascc�County Ordinance n�mber 89-47 and
<br /> I 90-07, as amende+d. .'The underslgn�d aiso��nderstand�; that��such 4ee�,,�as,may*_be�=dne;=w!!l�:be ldent�ted at the time of�
<br /> p��m#tti¢�g. !t is iurth�r und�rstood th�t Tra�sporkatlan lmpaat�ees and°�6�,esource Rec�u�.ery:Fees.must be paid p�or to
<br /> eece��in�s°c�rfmcate gf occupanoy" or flnal power�eleas�. ��the project�do�s not involve:a-�certfffcate of o�cupancy,.o��
<br /> �in�l pov�er rele�se; ihe�fees mn�t bg patd prtor to permft tssuanc�. Ft��thermore;�i�-Pasr.o County 1NatedSewer Impac#
<br /> fees are due,they.must be�pald-pi�ior#o permit�tsst�anee=in accardance vuitF�'appificabie Pasca.County vrd3nances. -
<br /> ��6d�TRU�Tit�P1 L41�h��1P�(C�t�pter 713��tottata��t�����m�n�fe��): �f dalua�an of�rork is�2�50Q.Ofl or mor�. !
<br /> ��rtiiy 4h�# 1� #he �pplicant, hs�e-been provlded with a �opy o#�ther"!�lortda�-Cons#ructton� LRen .t,ain�—�Homeownec's
<br /> Protectt�n Gu1de" prepared by the Floi�d�Department of Agrlcuttur+�and Consum�rAffairs. If the appl(can#ts someone
<br /> mfh�r l�an the"�wner`, I certif�r Qhat I�h�ve.,abt�inatl-�copy;of.the:above.descrit��d�iccument-and:pr.omise�in;g�od faith ta
<br /> delider it 4o the°ownec`prior to-comm�ncem�nt. ' � . ,
<br /> ��R�`�'Rr��'fi�R'S1AlAiMER'�I��iF1Ar�Vi�': i.c�itiiy fii�t atl.��he��,in�'ormatl�n.in thi��ppllcation is accurafe.and that alt vNork ,
<br /> �riil'be d�n� in +carr�plianae with aii.appltcabte laws reguf�ting c�nsUuatlon, �qreing and.�land cfevetapment. ,�ppltca�lon is
<br /> 9�er�by made ta crb#a1n.a.petmEt to dct_�w�ik:.attd Ins#aflat�on �s Indl+�atiad:.. :! cgrEif�r that �o v�rork �r tnstallatton h�s
<br /> commenc�d prlor to Issuance of a permlf and #hat.a!! work w11D b� perform+ad�to me�t standards of all laws �egulaking-
<br /> conshvction� County and City ca�es, xbning regul�tians, and land development r.egulatlons•In the jarisdicttan. F af'sa
<br /> cerOffy that ! uc�derst�nd thaf the regulafion�of other�gad�rnm�nt agencies may�appiy�#o th�intended woHc, and that it is
<br /> my r�spon�ibiiity 4o identify.what.acfions 1 must�ta�e:to b�dn>c�rripliance: 5uch ag�naies include but�are.nat tir�ited to:
<br /> - �apartment of E�lvironmental°Prcitection-Cypress.��ayh�ad�; 'NV4/etlat�d Ateas and Environmentaily �e�nsitiue
<br /> i.and�,1�laterlVifastew�te�Treatm�nt. .
<br /> - Sauthwe�t �larida Water !ulanagement:Distrtct-Wells� Cy�ress.Y�B�y.heads; 1�letland �4reas, Aitelring
<br /> � Water�ourses.
<br /> - Armb Corps of Eng(n�ers-�eawails, Doc�s, Navtgable iNaterways.
<br /> - Depar#ment of.Heatth�:�, Ret�abititativ� SeeviceslEne�ircanm�ntal He�1th tl'nit W�ll.s, VV'aste�4�r Treartm�n#,
<br /> Se�tic Tanks. � .
<br /> - US Envlronmantal Protectl�n�1gsr�ay�bestos aba#emen�
<br /> - Federa!Avt�QonAuthorlty-Rurnvays. �
<br /> I understand that the fopowfng.rest�lctions�pp�y to the us�of flll:•
<br /> - Usa af fiU is no#aitowed in Flood�Zone"t�'untess exptessiy perdnitted.
<br /> - If fF�e fiA ma#eria} #s to be used�1n :flood Zone. °A", it fis under�to�d #hat a drafnage plan a�ddresstng �
<br /> °compensating valume"w311 be subml4ted a��(m�o���rmitt�ng�rfiich !s pr�apared by a prafess(ona! engineer
<br /> 1lcensed by the�tate of Flo�da. � � _
<br /> - !f the fll) materla!:I�`to ba use� in Flood ?mne °eA° in�connection��ith:� �ermitted bailding using stem waii
<br /> � construction� I certify tha�t flll:�r111=6.e used oniy.to.flll the-area withtn�the�stem w�it.
<br /> - tf 4ill r�aterl�t is tc� be used-Ir� .any ar�a, 1�aertiPy #hat .us� �f such f{ii wil) rtot adverseiy affec# adjacent �
<br /> pr�pertles. If��e of fitl is focrnd to srdverseiy:�ffec�adJacent�pr�pertlas..the owner�nay b�cited iar vloCating
<br /> 4he cond�ions caf ttt� buiti4ing:perttiit lssned=undee#h��tt�ched{�ermtt applicatlon, for-lots less than.one (1}
<br /> a�re v�rhhtch ate elevated�by fl!!;��t englnsered drair�age plar�(s�equtred, . ..
<br /> ��9 am th��4,��N�`F91�TH�AyVIa�IR, I�.�romise in good�aith to Inform the Auvn�r�pf the permltttng condi�ons set forth in j
<br /> ghis affid�dlt�prior to comm�r�aing construction. i undersfand that��separat� permtt m�y be re�qvired for etecMcal w�ork, I
<br /> �lumbing, sdgns, welts,.poatsr_ air conditianing�.g�ts, ar ot��r fns't�fl�tions n�E.speciflcat(y in�#uded�in.the�apptEcation. .A
<br /> �er�nl#I�saed shal! 6e co�stru�d ta b��a=t�cense°to-proceed with'tlie�nrork and n�t as.authoriEy.to.�iola�te,�cance{; alter, ar
<br /> s�t asfd+��ny provistons of the#�chnlc�)codes;�nor shaU issuanc��of a.permit.prevent the Buildlrig OfFtclat from thereafter �
<br /> ` requir6ng�correctlon af errors in.pians;�construction or violaQons of any codes.� Ev�ry�p�rmlt issuetl shall�become irnralid
<br /> unles� the vaork aa�thorized.by such permtt:�is_co�nmenced�wtthin six month� of�penmlt iasuance� or if work autho�zed by
<br /> Qh�p�rmit is suspend�d�or.abc�ndoned�for:a:period of:-�i�c��}-monfits.af�er the ti�e the�wark>is commenced. An exfension
<br /> ��y be requested, ln writing�.fro�Et►e�Bullding,t�fficla!f6r a pert�d�nat-to�c�ed n[nety�(90)-days si�d�wrill demonstrate �
<br /> ju�t���b1e�ause ttar�th�exlenslo�: !f�ork ce�s�s:f�r nlnet�{9Q1 consecutiv�daxs,..t�ie�ob�is.constdered abandoned.
<br /> �f!l��MlidG 'T� O!l�NER: 1lOUF�..FAILU1tE-TA RE.COtti� A�dGTIGC.AF COMMI�MCEMEI�T�AAAY�RESULT IM�'Xf�UR
<br /> �r�1Vi�dC�'P�MIGE FAR�IMIsROVEMEM�S T�3�fOU6��P�PEt�TY.�I��YA��iiV��D:TA��TA�iN�fiN��l�iNG;�ONSUI.T
<br /> �ti� Y�� d �t�. Ad(�� tS�F2N F�R ` �E�- t��4YaUi�' � �� 'aF:. < . E
<br /> EI.ORIDR JUR1i�-(F.S:t17.Q3t _ , . _ . . . ..
<br /> OWMER OR AOEPIT Ct}NTRAGTO .
<br />; Subsai6ed and swom to(ar�ti9cm�cf)before me!h!s Su ed'and'svwm�. ( t at�rmedr te me'tti1G
<br /> b� • ��by 1".r.�.. �l.�:o�
<br /> Who islare pe�sonatiy knorim to�me or hasfisve produced a.s/are�etsonally known�.me ar tta�prodisced •
<br /> ,as IdenBAcatlon. ,�//tyP�'S ,G",���°O , as tden8flcatton.
<br /> �� Notary Pubiic . ` Notary Rubltc
<br /> Commisslon No^ Camnnls�lon.tdo. �1" C3I�- .
<br /> �_,h�� �/�r.� �'.c��'�l/L.'� .
<br /> Mame ot iVatary typed,prl�ted cr stamped Nam�cf Rlotery typed,printed or stampa
<br /> ' BtO1i8E-OOB�uemsul�le3+��+1Mi.tP�F��` .`�'o�Podr4�:
<br /> OZOZ'G��q�anoN sa�Ed��:.°•�„_
<br /> £ti£S�0 JJ#uo�ssiwu:!+�:;'•. ''_
<br /> -,_ -— il��d(121�NI1f131fLii?:IU '3;+3a�u„+,�`�;:
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