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l <br /> �t�'�B�E t���EF�RE�TR�CT1��+1�: The�a�a�,es�lgn�d�c�nder�t�ind�:#�t,s�hl�..p�t;r.��f��.m�y.;b�,s�ab��c�t�,,"c0�ed"..rasR�6�tleri�°��.. :,�_ . <br /> whBch m�y�be�r�oro-rest��et�e�'t#'a��'�County,�re8ulatioeis:�°T6a�`�under�lgn�.d:�ssum�s'�e�pon`a6b6lity'for coir�pll��i�e'w1th.`any,`. <br /> appl8�able deed�t�sQrictions. .�.�.. < � . <br /> Uk�9.t�EN�ED COA�T�CTt��� �a�D �ON'�►�'��R��E�PtiNSi�l�:l't'�E�: �f=ttie-owner��t�sx.:�6r�d���":co�t��c#or �r <br /> con4r�ctor�s to undettake work, th�ay may;b�:.r�qulr;ed.�o;b�:�ll�ensed In;��rd�r�ce.writh,st�te�.and�Igcc�I,t�agulaQlt�ns::�zlf'the� � - <br /> �ont�act�r Is�n�t �Oc��sed-�s��r���Ir�d��Eiy la�r� bott� th� �er arii�>+co�t��cto�-�m�ry`b�i���tQed fos°�'�mOsi�ame�,�o�vlo9atio�e <br /> und�r �tate lawr. Of the owner�r Intend�d;��n�raCQoPne�re,,uncerteln �s @ei wh�t Ilcen�png.requlrenri�rats,m�y��appiyr:�far.-%th�-< �� <br /> ��t�nded�ork+they�re�dvlsed�o+�iiiQ����ti�.P�sco Cai�nQy�uileling'{��pe�:tfon,Dhii�loei--Ltcen�ing 3ectlon at�27-�l�4�- <br /> ��0�. Purth�rrnaaee, if the ov�ner tia�`hli`ed s c�nt�iact�r o� contr�ct�r�� he 6s �cBvt�et# ta� have�th� cor�tcactor{s};.,sl�n,., <br /> ��: ..,.;<,,..�,. _ . <br /> porti�ns af th� "contractor Bl��k" of thla,.,appllc�tion..far.;whluh.they will...b�.te�p.onslbl�.•....If.--you;�as�:lhe owrier sign'�ai�'tlie� '' � <br /> c�ntra���r, thaE�ma�t'b� �r� Onti6�at�a�t th�t lie i� not:pr�p�rly 1ic�nseif �ntl`'i��ri��en�t�ed`�s�p�eti�tlt�ing prtr�lleges�n Pasco , <br /> County. V : �� . , <br /> 1'��I��CIRTAT�Ot�=lMPAGTIU'�lI:ITlES�IIIAP��'��►t��?�l�E��URCE RE��YEEtY�P�E3: Yhe�u�td�tslgt�ed-u�id�e�tands <br /> thaQTr�nsport�tt�n impact Fee��a,v►d.Fdecax�t�e.Rec�v�P.y.�e�as m�y;�ppiy;.ta�t�e:consU���on_of n+�v�r...building�,°ci��n�e�f�f` `� ' �, <br /> use In ex3sting bulldings, or,expa�'sibn�of��ie6�tiri�=�b�iiltling�� as sp�cifled.On P�scQ C�a�nty O�dina�tce ra�rnbe�89-07 �nd <br /> 90-07, a� am�nd�.�.,,_.T�� �nde�0�ned�Ise�s=���ersta�ds, �h��:�such f���;:5��f-cr���,bs:�du�;;�w11�;5l�� id�nf�#t�d at th��tiii��e�o#�°. .�.` ` <br /> pernnit�ing. It Is fiarther under�400d @h��Tr���p��rtatlan Imp�cf Fe��s �ndaResoa�r:ce�;R�covery=Fee�,.mu's# be p�ald p�8�r to <br /> receEvi�g-a:'csc�Ffc�te.of�occup�ncy" or�rtal-:power.�e.1'ea�e; :4f�the.pr��c4:�does�,t�ot It�v�lve�ahc�r�4�r.�tie �f occs�p�n�y{or;<,-;,:.,.:- <br /> :. . <br /> finat pmwer relea��;:�the°fe�s mu�t'be"paid.pr�or to.,pecmEt is���nc�. Fu�k���mareo�f 1���ca,Caunt��llVat�rlSew�r-;impac# � � <br /> �ee��re due,.lhe��..mustb�,pald.;pNor to,permit�:l�s.4�n�e;:in.�ccordar�ce witFi:��ppltoable:P�sca'�,Count�•or+dinances. � <br /> ��6��TRt�Gi1{?N�IE�t'�L�C11V(�fi�pt��795���t�r�c1��#���s�a�am����d�: If v�l�a��on ot�nr�rk i��2,500.o0.�r.mor�,..�� ,. <br /> cer�ify that I, th� �pplicant,-h�ve.b�en pP�r►Ided�wlth• � �tapy r�f��the '"Florida� �an�truction�-L-len.:Law--Qiomeown�r's <br /> Pratection �a�ide" prgp�r�d by�is Ftai�lda� D�parE�n�nt of�gr0�uit�r���� Gonstam�r;.A�fiales. If th� �ppltc�nt is sot�eon� � .. <br /> oth�P than�he"�nrner", I�ertOfy,t..that.;l hav�.�bt�in�d�aY �c'opy;�f:th���babe.:a��acritiedtia�ui�ent�and.pro�ise�,.l�,g�odfaikh.to , <br /> d�liv�P it tco the.°owrie�`:p�ior°tapammmencement:' � ` . <br /> ���TF�ACT�R'�90oNNER'9�A��ICtANiT. i.ceitlt�r:.�tti�t��il..#h+��info�r��tiom:l�t�this applic�ttora 6�aaca�r�te�nd t�rat aii veork <br /> wiil'be doroe in complia�nce with all appi0c�ble laws regtal�ting cor�s�ructlar�� zontng and��land�developmer�t. Appllcat0on is <br /> �er�by �t�de �ar obt�ln .a perm�t.�:to_do�wrorDs:;�nd :litsta#I�tion �� indt��f�d;�---�°0 c��t�y #h�# no w�rk�or tnst�lla#�iii� t�as <br /> commenc�d ��tor to is�uan�e� of a p�rmit antl th�Q�.�lI work will be pe�'imrmed fo m�a�t standard�-of a�li laws r�gulating, <br /> co�rst�uoQl��tt �aunty �nd Cit9r s.�de�, zo�ing r�gulat6�r�s, arad 4and ����I�pment regulatlon��tn the��trl�dlctt�n: I�al'so <br /> c�r#3fy that I u�d+�rsfand�hat the reguiatia�s�f tather�gov���rrdent�g�nci�s m��s��pp)y�to the lntend�d�trork, and that it ls <br /> my r�sponslbiEity t�identify•wh�at.acQlans I musQ•t�ke:M,6e,in:.c:orrlpllat�c�; �uch:�gencl�s include but��are.not lomited tc�: <br /> - CS�p�rr�tm�n# �f Et�vic�nmee��a1��19rotacf#oii�Cypr��s.'Bsyh��d�, W��and Areas a�nd Envtr�ncner�t�l9y See�sitivs <br /> Land�,WatedWaet�water Tnsatrr��nt. � <br /> - Southwr��t Fl�rld� Y9t�ter Mar��gtem�nt .:���trlct iNe�ts, CYP�ess.A.��y�t��d�. VY��tia,¢��i Areasg Aiterc3ng <br /> 9Nat�rcour�es. - <br /> - Army Corp�of E�glneers-Se��u�ll�,Docks, N�v6g�til�1fVat�r�r�ys. <br /> - �ep��4m�rrt �f. F:��a�2h;"&..Ret��blt€�atirr�.:S�nrtc�stEnv6tonm�r�#al.He�lth lda�it Wellsi W��t�Htatert Tre�t�nent, <br /> Se�#ic Tanks:. . <br /> - U�E�erf�nr�ental Pr�t�c#i��A#�ency-Asbe�to��b�#�m���. <br /> - Fed�raB Av.ietion:Autho�tiy-#�unw�ys. <br /> 1 under�tand 4hat ih�follotivirag=restrlctl'ons apply'tb the u�e o�fiIIL•• <br /> - Us�c�f f�91 is�ot�Itavv�d in�Flo�d;�ane"16"�a�1e�s�xpr�ss�y p�rrnittesd. <br /> - If th�-�ill materiai is #o�b.e u�etl:'In �Flomd Zone�. "A", Ot. Is und�r�taod #hat � dra(n�g� pl�n addr��sir�g a <br /> "c�mpe�s�ting vot��n�r"wll� b� sub�ltt�d at�ir�e��-p�r�i�l���u�ii�h �s pr�p�red by � pra��ssi�c�al �ngin�er <br /> Iic�ns�d by'#he 5#ate ot���iotlda: . <br /> - If Qh� �I! msteal�l-!s to be used �� F'Iciod �bn� "A" !n�ccann��tl�n�avlth�a permitt�d buNdi�g u�fng steen av�li <br /> ' cons4rucfion, i c:�o�y that f�i:�il-b.�us�d�n6y.to..fill th�ara�witt�in�the stetn�wraiL . <br /> - 16 fl90 mat��lal is tb be used !n �ny �,re�, I c�rQl6y ##��t .uee. of'such flll wlll not adv��s�ly affec� adjacent <br /> pe�p�rtles. if us�r af f�ll i�#�t�rtd to�idv�r�eEy,�ffect�d���a�t prapeati��.th��wn�r may b�c1f�d fo�vtoFating <br /> the condl4la�ns.of the bc�ilding�;parmik i�sueid�un��r the��t��ch�d.�rmit �pplicatlon, foc:loQ� le�s than:�ne (1) <br /> acr�v�rh6ch ara elevatgd�tiy�D!!,��er�gln�er•ed dr��nage p0a�i�r+�quired. <br /> Of i�m the AGENT-�OR TH�,t�1�1i�lER, I;.prtorv�iae In ga�d f�i#h to i�foPm�t3��ow�ner of�-#h�permtt�ing condit�ons set�orth tn <br /> lhi� �fYidavi�`prioa� to comrriencin� cansi�ctEon. 1 underst�nd th�t,��.aeparate p�rmlt nnay be requlred for eleat�icaf wrar�, . <br /> pla�mbOng, signs� r�elfs, po�P��.��r c�nd1#fi�roir�g,.��s,-.or �fF��� 1nst�11�'t�ons n��,�pec�c�l�r �nc#uded�d�.#h+� appllcat3on. .�e . <br /> permit Issued sha�ll be cons#nu�d to b`�'a�If�nse°�to`-pr��eed�rlth tfi�wvork�nd raot�s.�u@hoNty�to,v1�9�4e, aaaicel, �Iter, or <br /> se��slde:�ny pr+mVls6�ns of the.te�hr�lcal_cod��;�r�or�hal!lssaa�n�e�aF a.p�Pmi�.pr.e�o�rot th��alldlrig t�tcfa!#�m thereafter <br /> r�quirtn.g a�c�rrectian ai ercors in��plans;c�n�t�c�lon or vfotatt�ns of�any cod�a. Ev�ry•pierrml�--issu�d sfie�l)b�ca�me inv�lid <br /> unl�ss the work �uthorized.by ��ach permlt:�ls.c�r�nmenc�d•�at@hin �c cnontha ot�pe�nit Isauanc�� cor ti work authoPized by <br /> 4he p�rrrptit is s�sp+�ncf�d,or:���do�ed-for.:�:�ettod.af=slae:{�}mont�i���t�r t�te tir»�th��wa�tc�is corti�nenced. Ar�extet�ston <br /> may be r�q�a�sted� In writirig,:�rom the:Build9ng,�Jff�ci�l for� p�rfod.,not to exceed'�nir�ty�(90��days �nd will demonstrate <br /> 3ustl��bie r.��se tor�the ex��nslon: ff work ceas��:for e�Ir���.��0}cons�cu�iue;day.�..,th�J�6�1s.con�td��ed aba�d�ned. <br /> �IARNONC; '�O C9��@E�it YC�IIR,,EAILWRE;T�.,.lREC:Q�D;A��:O�IG.lE:OF��COMMI�M��ME#�T-,M�AY•RESi1�T-�P! �P�O►UR <br /> ��►YIN�T1MI�E;;�F�t�1M�QV�lI#EN�`S�TO.:Y�t1i�:;P�4�E�T1f�ii�°Y�.E�+1�'�E�D�i�Q°��ti�TA1N�=FtQ���1NG'o'GOEI�ULT <br /> l�kllT A 'fT�71 �R��� G� OIJ `' ;�A �' � � <br /> Ftf?RIDA JtiRAT_{F.S:4.17.03) . � ; . : .,. . . .. . _ _ <br /> /� - ',,,...r-- ' _ - �_.-- <br /> C3F�,°o`���3 3;.i 6�i��F1�' L��~' C-.....�"� CONT�ACTOQt ����'""'�r � <br /> S bsatb d d swoec►M(or atNrmedj before me this Snb�a�lbe�and'awom 4c{mt'a�inn�dj�b�ba�nte�ttii�: ' <br /> 1°�r��bY 'p `��1�.��Y ... <br /> Mifio I�/are per�onelly Bco�ovvn.ta.me.or•ha�lha�e produced Who.i�l'sre p.�r�onell��Cnown•kt�.me:orNa�have�produced � � <br /> �s I�entl�ceflvn. a�ldentlflca8an. ' <br /> ,����._ �����tafary Publtc , a • �' ti E!o#ary�'ublic <br /> �ommisslon No: / �G� � t�rrols�lon.Na� �� G,� �,.f,,,�� <br /> ��,�1� �/�/�` �����c_.. � � U �f <br /> Name op 4dotary typed,printed ar st�mped Rl�m�af Plota �d, rint�s! <br /> ,,,,„ � C�fi��,..... �--;:-Rt7FFE{.l <br /> ,� Y��+,r � 045343 <br /> ..;�K,;�rn.�� ti;:.:. <br /> �tY, k sa? `k�'""�;- �� ��,y, <br /> �is" � ''LAIA:E f2UFFELL '*' � � 4 <br /> c C.�' :.3si.!it �r'Elt�tfTk'�'. �0� <br /> o �cits?� :Z��G Q45343 :'+i ue�+'T� -",0-36rrT019 <br /> �. %.;'o�N,.•` Bot�dOd' <br /> � �:�F�:�'"„�;'e=, ,�;��rnber 7,2024 �.4�.�,�,,.,� <br /> �"'%�$;;„4'� 6oilr:uuiur.°„.r"aintasurance80Q-38�7053 . <br />