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<br /> � . NOTiCE pF DEEp RESYRICTION�: The und8rslgned,under�tands�<th�t,ilUs_}�rm(�may_.be,subJectto'deed',restrlcNoris°.__. c� `
<br /> ' whtah ma'�be:more'i�stticthre-#1ia�t'Goui� ist(ons3:�TFie��ndef�s naa��a`saumes're`s"nsibili` for"com 1lence wlth`an '�. �: '�`
<br /> v t3+�� �e" r� �r a y
<br /> app!lcable.deed reaMctlons, • �.�, �,,.,, . �:.u
<br /> _�s.
<br /> lJNLICENSED�CONTItACTGRS°AND CCMNi'RAC'FOR RESPONSIBIGRIES:. If�tlie owner has°•hlr�il��a�conh^aator or �
<br /> contractors to underEake_work�they may,be;,�qiri,r,'ed•<ta,�e;ttcensed tn;accc�ti3ance.with•elate.and,locat regutatio�s::�if-'fhe`.� ; j:, �
<br /> contractor l`s-not llcensisd��as requlred.;`tiy la�N,.both°the bvmer and=conliactor`:srriey'be�citeif'�for�a�misitemeanar viola8on !
<br /> under�tate►aw. IC the owner or intended>,;conaraclor,;er,e:yncertein es to whaf Ilceneing.reguirements;may_eppty�ior tfie°> • - - '
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<br /> t�tanded vuork,they aie sdiii�eii tb can#acf�e.Psaco.County,By1{diag;tnepecfion Cil�is{orr-�Ltcensing S�ctton at�27-847-
<br /> 8009. Fiirkhermore, If the owne� ha��'hlreii a conliacfor'o�coritrecMts. he Is advlsed ta have the centractor(s)_aign. ,,, i,.
<br /> Yt�'-.. �...,
<br /> porUona ot the"conhaator.Block of ihis•appllcatian_for,.:which.they wIlL,be,.responslble.•. It�you,as�.ihe owner'�fgn`"a's`the`` ',
<br /> contrac�or,thatmay be an Irsdlcatton that he°Is iiot propedY iicensed�and"i's''iiot'etttitfieif tb petfiittttiig'pviullega§(n Pasco ,�. i
<br /> Counly. ` � ._.. __.. .',.;:::�•;:� ,� .
<br /> TRANSPOItTATitlN-1MPACTIUTILCEiCS�1�YIPdC'r�AFiCt-R�SOUttCE itECOVERY�FEES: '�e untleralgned understands �
<br /> that Trensportatlon lmpact Feas:artd.Recourse RecoYery.Fees may;appfy�ta�tite�consttc�ction;o�new,buEldtngs;?change�'of} .M1 ���
<br /> use In exis�ing bufldinga,`o��,eicpangiorr of�zisU�i,g`�uildings,as apeclfied.in Pasco County Ordinance numbar 89-07 and
<br /> 90-A7,as emended:;T�se undersigned aiso:understands,th,�4'such fee�;,as,majF�e��due,;wfli�De IdenUfled at fhe.iime°of�'
<br /> permitting. !t Is fiirlher understood that Tra�isporkatian Impacti`Fees and'=Resour�s�Recb+r,ery=Fees.must be paid prlar to
<br /> reaetving a.'cerfl�flcate�of occupanc�'orflnal=powe,r.�;r,elease: :I�the proJegt,does;riot�lnvolve=a:certiflcate of occupan��o'r"-r���^�"� ,
<br /> fina4 pawer.releasa;the',fees mu�#"6e pati!;p�tor to,penmft tsst�nce. F�ethermore,�i�.Pasco_Gounty'1Nater/S�wer,-:Impact x
<br /> fees are due,.lhey musk.be;pald;pricr to per�nR.lssyaq�in,a�a�nce wltti:appilcable.Pasco�:County ordinances,
<br /> CONSTRUCTION�LIEN"LAW(Cliepter T1S,�lortde Statut��,as�mende�: If veluadon af work is a2:600.00;or more,l� �
<br /> ceftliy that (, #he appllcant,-have been.provlded'with-a capy��of the�`Ftarida°Const�citorr i.len�Law--Homequvne�'s I
<br /> ProtecBon Gulde'prep�red 6y,�ie�Floiida Dep�rtmenC of Agdc.ulture and Con��mer:At[aUs. !#the appilcant is eomeane , � �
<br /> other than ihe'owner',I certi '.th�t l have,obtalned�a�co oLthe:ab,Rvadeacr1bed�;doa�iient,and;, mise;;ln;gaod.faikh•to . 1,�,
<br /> deliver it to.the;"owrier??=pitor-'�co�iriienc�riienf;' _ PY; . _ : pro -
<br /> CONTRACTOR'SIOYYNER'8/1FFIDAVlT: !ce.rt4�y.�ttiak<sll�the.It�formallon:l��thls appllcatton}s accvratb.and that a!t work
<br /> wilt'be done In compllance wfth alt.appllcable laws regulaHng construcilon,zoning and fand development Appllcatlon ts
<br /> hereby made ta obtaln.a.pennit::Co do.:wo�.and thstallallon as Indt�Cefed;-=1 cet�ity that no work=ar.installafian fias
<br /> commenced p�{o�to lesuance ot a permit`and thaC;all work wfl!be pertarmedto meet_standards-of stl laws regulating�
<br /> conshuction, County and City codes, xontng regulattana, and land development regulatlons'tn the Ju�sdlctlon:� I al'so.
<br /> cetklty that t understand that the ragulattot�s of other govemment agertetes may��pP1y�#o the intended work,and that i#is
<br /> my reaponslblltty ta Identlfy•whet.ecUons I muak�take:to,be,In;corrlpllance:,.Such,agencles tnclude-butare.not Ilmfted to: < -
<br /> r;,. ,.•., ,
<br /> - Departmen#of E�vlronmentat��protec:tion=Gypr'"ees.'8ayhead�;1NeNand Areas.and EnvlronmenNally Sensitive ,
<br /> Lands,WaterMfastewater 7r.eatment.
<br /> - Southwest Florlda Water Management:blsfrlct-lNells, Gypreas`�Bay�►eads; Wetlend Areas, Alkering
<br /> Wateraourses. • .. `
<br /> - Army Corps of Englneersveawalls;Qocks,Navlgable Watesways.
<br /> - Deparkment of�,Health;,�.,:RehebllR+�tivs:SenilceslEnvltonmenYal Heafth Unit.Well,s; WastewaterTrestmont,
<br /> SepBc TanRs:.�"� � - , i
<br /> - US Envlrohmental ProtecHon Agency As6eatos abatemen�.._
<br /> Federal AvlaRon�Autho., .=Rurnve s. �
<br /> �Y.;.,_ . Y �
<br /> 1 understand that the,foliowlqg::`t�esfrictTbns appty"to the use of 811r
<br /> - Use of fill Is not allawei�In:Flood.Zone"V'unlesa expresaly pecmltted,
<br /> - If the-fitl-materlat is to bs usei7'In.:flood Zone.'A', It ls underetood-that a dralnage plan addressing a ;
<br /> 'campe�tsating volume"wIN be submttted a##tm�of�pe�m�ting whfich(s prepar�d by a professianal engtneer
<br /> Ilcenaed by'the State of floflde: " ��
<br /> - if ih�fl11 matertat-is�to be used in Fiood Zona'A"in�connecfion wlth�a permitted bupoing using stem wall
<br /> � constrs�cNon,!certity tha#flO:�Vl11=be t�sed only.to.fi0 the area wttfi�in:the�stem wali. �
<br /> - If flll materlal Is to be used�ln.eny erea, 1 certKy that.uas af�such fll! wlll not adversely aftect adJacent
<br /> prapertles. tf use o1�tt ia found.to adverseiyr.affec#adJaeent�praperties,.the owner may be clted tor.vlofating.
<br /> the cond�tans.oElhe.btiHding3pernilt!s"sueil�undar tfie��Etar,�ied permft eppticatlon,for tots less�-than.one(1) �
<br /> acre whtcFi are elevated•tiyi fill;�n�englneered drelnag�plan Is requlred. �
<br /> !f!am the•AGENF FOR;THE-ONINER,.I�r`oiri1se tn gocd.faitk�M tcdorm the owner af the permitttng condritons set forth In
<br /> thls affidavlt'p�lor to comrnencing consttuctlon. 'I un�erstehd lhat anseparate permlt may be requlred for etecGicatwork,
<br /> piumb�ng, signs,we0s,.pools,.alr aondltloning„gas, or ot�e�Instetl�8one not.spec�lael�y(neluded In#he applfcatlon. .A
<br /> permlt Issued shaft be ca'tistrued#0 6e�a°license'-to"praceed with fttey�6rti and nat as.sutharityto.violete;cancet,a(ter,or
<br /> set astde any'provlslons of the.tectia(cal..codes;:nor shall Issuance�of a.permlt.pr.event the 8u!ldlrig Ofttcla!from thereafter
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<br /> requiring"a correction af errara in;ptans,conshuiotion or vlotaitlona ofany codes:�very-pbrmlt=lss�eii sfiall�beaome invaUd
<br /> unless tha e+rork authwlzed•by such permlt:is.contmence�•wlthln sGc,mrmths bf•permtt Issaance.or Nworic authorized by
<br /> the pemtlt Is suspended or:ebandoned for a�pertod;of�slx:(8)montiis aRer the.tlrne.the�work ls co►rimenaed. Ar►e�ctenslon
<br /> may be requested,in writirig,;irom,tFie;Buitding,t3ftfciai for a period:not.fo exseed-ntriety(90)�days and wlll demonstrate
<br /> JusR�lable'cause for.�the ea�enafor� 1!'wark c�as�s:for nfnety(90}+�ns.ecuthre�days,.t�e job-ls consfdered abandaned.
<br /> WARNIN6 TO OWMER: YOU�t:EAiLURE.T{2aRFCQR�:A>t�OTICE:OF:CO ENE�MIEM'�NtAY<RESULT IN YOUR
<br /> PAYING7WICE�EOR=IMPR1?\IEMEN�"�:T�"lsYQU�PROPERTY:"IC.�-YOE1+ . ''�Q',(�J`8�''A1N��FIRFFAls1+lE1N�'+'r�'i0�118Ul.7
<br /> U D O - �Rf1 E��, �O E
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<br /> FLOftIQA:lURAT{F�S.tlZ.Q3j , . . � .
<br /> 4WkER OR AGENT-- - CG ' I
<br /> Subaalbad an�m Eo(or eNirtned)baforo me fhle �S' sal �bp(o' 7b me' ' +
<br /> Who Islare personally knovm to me.or;hes�hqve prqducad, o are Ilyknown to me,or��dhav uce � , ,
<br /> � aetdentlficAtl4�. + aat ndflcadan.
<br /> Noffiry Pttbttc . ('"1F�.r���.t�t'����1.,J��(�J,G 1,�,,,�Notary Publlc ,
<br /> Commisstort No:' Gomm�aton.Ma. '� ���y �
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<br /> Name of Nofary lyped,ptlnted or atamped Neme o f �
<br /> ��"��p' DEBRAELAINERUFFELL �
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<br /> �,, •,y Commission#GG 0453d3
<br /> :'*,;�o,:Expires November 7,2020
<br /> � �,�o�Fu�Q•' BontledThruTroyFainlnsurancsBOD-365-7019
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