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<br /> �90'P9CE OF D�EE�.BtE3'TRE�TIONS: Th�und�rsign�d und�r:�tand�;th�t:�thi�.�.p�rmit;may,b�.subJ�ct to,"deed'°,r�s4ricqpons°_.,;:-ff.._ ..,_.;_;
<br /> which may tie:more��re�trtctive�th��'County�reg�ilatlons.��The°�undecslgned°assume's`�re�p�n�ltillily'.forLcompOtatrc�ewith�any :
<br /> �ppiicable.deed_res4rictions. :..:.�_ �._; �. , . . . _ . _ .. ._. ....,___...... � . ��� � •
<br /> lD6dL�ClEN�lE�`�CON`T�ACg�RS AND �ON�i�C7'O� R��PON�9�ILITOE�: I� t�re�owrn�r h�sA°h9r�:d� a.�;contractor or
<br /> contractors to undertake work, th�y en�y;b�;re�quir;,�d•�tm-,b�.;ltc�na�d ln:accordanc�,with,:stat�.�nd�lo�al regulatlons: �;if�the � � -
<br /> con9ractor ts not Oicensed�as�r�qulred,`-tiy I�iv� both•the owmer_and'cont�acto�°�m�y°tiesclted�for�°a�nrisdeme�nvr vtol�tlon
<br /> undar state law. If the ov�rn�r or Interided;,;contractorrer�,:unc�rtaln �s to avhaf Ilc�n�ing:require�ee�ts.,'may+:app0y�-fcir�th���:� � �”
<br /> int�nd�d 4niork, they�re advsseit;#o cont�ct tF%e Pasco:!��untp�Bulld(i��`@n�pectlon'D�vlffilon.-Ltcensing�Sectior��t 727-847-
<br /> 8008. Fu�h�Pmor�, If the own�r`fias`hOred�a�a:ont��c4or oP contr�c�ors, he Os �dvl�ecl to have.the con��ctoc(s)__�Ign t„
<br /> , .,.,..,,:_.,.���..�,�.,,::,<.:., - ;.
<br /> por�Ions of the,"contractor �lock° of thls_.�pplic�t(on>.f.or,.�vhlch...they.vail�.,b��r��ponslble.-.-if.-you�:�s•:�he ovimer��igri"a�`the"" '
<br /> c�ntra�tor, 4h�t tn�yr b� �n lndicatlon that"�� Is'not.properly B1c�ns�dA��itl 9s-not�ntftl�d to�pe��itting privil�g�s in Pasco, f
<br /> County., � . .` E: ;.==, . _..
<br /> `�f�e4(d����T'�TION=1fNPA�`T/UTIUTIE��BMPAC`�A�b�tESOdJRC�R��OilE�81f°�FEES:"The un��r�igned�u�d��tands
<br /> tP�at Tr�nsportation Impact Fe�srand.R�co.urse.Recov�r.�nFees_�i�y;;���ly.�t��the;conatruction of_newhbuildings9�ch�na��-of'� '° '
<br /> u�e In existing bui9dings, or=.�xpari�le�rt:of-�eiiistira,g.;li�iild��gs, �s specEfled.In P�scv Coure�r Ordlnanc� number 89�07 and.
<br /> 90-07, as amended.,,_The undeeslgraed �il�o.urtdersta�ds, 4hat�such fees;�:as���ay;�e�..due;;vuili.��e dd��itifi�d at the-�Qime4ofi'f - _
<br /> p�r�nftting. I@ I§fui�Ner understood that TPa�sportation Impact'YFe�s ari�t���Resou�`aRecov�ryif��s;mu�t be p�ld prior.to
<br /> � e�ceFvireg a°�erf�ic�te:o��occupancy° or flnaF�pov�errel�a�e:- :t�rEhe.pP�j�c�..do�s;n�t Involv���::certificafe of occupancy�or-=������� �
<br /> ,,.
<br /> fin�l owee r�0��s�;�th�:,f��s_rr�u�t b�"p�id;pe1o�to p�rmit Oasuanc�. ,Fu�th�rmo��;:If:.Pasco County��Water/S�wer;lmpac4� - "�' � I
<br /> P
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<br /> f��s are dueo th�y;rnust:be p�id.prlor t�_permit�.l��ua�ac��:ltr�accortlanc�-=wtttr��ppllc�itile Pasco�Coun9y orr�inances. •
<br /> �Of�STF8UC7'9�M'L"IEN"I.A�V(Ch�p3�r 7°d3� Florlda�t�tut�����r�aended): I�veluation of work is$2,500.00:oc more, I-� � -.
<br /> cerlify th�t I; Rh� .�pplic�n4;: have.-beere pr:�s�rided �wtth-a °copy of'4he�-"Fiorida��onstnactlon::Lien :Lav�Ho�neowner'�
<br /> �rotecdio� Gulde" prepar�d by tHe Flo"rid� Dep�rtme�t of AgrEculture and Gonsum�r:�4ffairs. If the applican@ 9s someone� : .
<br /> . ., . �
<br /> other Qhan 4h�tlown�r", i cer�f�y,.that I�.h�v.e..,obta�ir��d1as�PY:o�:th�;�b�y�::d�sc�tbed�docu�ent°and;,Ppomise�in,go.od<f��h•to -
<br /> d�liver E@ to.:tlie:"o�vnee".p�ior':to>cornr�ence�tieoit'''' - � M � �
<br /> C�RITG�ICY��'SIO�VNER°�AFFIDAVI7': 1.c�.itify<:.tF:o:at:all,:th�;InfoPm�tlt�n�l���thi��pplicatlon is accue�te�nd Qfiat�19�nrork
<br /> will'be don� irr complianc�with al! applic�ble laws regul�ting constrtactlon, zoning�nd°land�de�elopment. Applicatlon is
<br /> h�reby m�de ta obtain .a .p�rmit �to.;do::�toork.;and tiosQallallo� �s tndlc�fed:�:��;1��certif9+ t��t no �nrork-=or Inst�llation has
<br /> commenced prio� 4o issuanc� of.a p+�rmi@ and that:aEl��+ork wili b� p�rformed to meet.standards.>of..all law� r�gul�ting�
<br /> �onst�action, County �nd CiQy codes, zoning regulatlo.ns, and land dev�lopmerrt regaslation��i�i the .Jurisdict(on: i �I'so '
<br /> c�rQify Sh�t I u�derstand th�t th�r�gulations of othe�gov�rnment�g�ncies may��pply.�.to th�._inter�d�d work, and that it is
<br /> nny responsibllo�yAto identi�r�w7��t.actions 0 must�take:to,b�.sin:.compl0anc�:,,Such.,age�,cies�lnclud�'but��ar�.not limlt�d 40:
<br /> - D�partrn�nt of EnvPronmerrt�i''Protection-Cyipr�sg:�B�yh`��d�; UVeH�nd Acea� and Erevlronrvi�ntalEy S�resitive
<br /> Lands,Water/VdO�stews�@er Tre�tia�en@. �
<br /> - �outhwest Florid� lN�ter N4anag�meret .Dist�Ect-VU�91�;' Cypress.x�Bey�t��ds�,- l�Y�tland /�re�s, ABtering I
<br /> V��$ercour�es. � i
<br /> - Arcny Corp�vf Engln���-S�a�v�Us, Docks, Pdavigable W�ter�nrayso �I
<br /> - D�p�rtm�nt,of..H{�alth-:.b.:Reh�bll(4�tive...ServtcesL�e�viro�rvren#al:Fl��l�h lD'n9t W�II.�, -VVa�teenrat�r�Treatrnent, �
<br /> Se�tic�Tanks:�.� � � .
<br /> - US Environme�Q�l Pro��sctlon Ag�n�e�Asbes4os�ba#�m�n4.
<br /> Fed�Pal Avi�kton.Authori.ty:-Run�ys.- � I
<br /> 9 un���stand tha,t the..follo�vlrig::re�teictlons apply 40#h�u��of flll:� ' '
<br /> - Use of fill Is not�Ilowed im Flood;;Zope"V"unl�ss expressly, p�rmitted.
<br /> - I� th�•�II matePl�l-is to b.e u�etl_:En.�flood Zone. "A", It. is tand�rstood th�t a dra0n�ge plan addre�s9ng a
<br /> °comp�nsating volum�" will b� stabmltted at tim� of;.pernnttting wh9ch I� prepar�d by a prof�ssfonal engineer
<br /> Ilc�nsed by tMe State�of flo�id�: � � � .
<br /> - If ih� flll-materBal�°ts�4o b� u��d fn Flood Zon� 'A" in�connec�Eon�tidith�� �p�rmitt�d �ul�ding u�ing stem wail ,
<br /> � const�ction, I ce�ify that fUl�:v�lll=b.�•used only.to.flli the are�withtn;the�s4�mvv�li. _
<br /> - � I� flEi mate�al Is to be used In �ny area, I �c�rtify that .us�. of�such flll wlll no4 ��ders�ly �ff�ct adjaceret
<br /> pcoper�i�s. !f us�of flEl i� found to adv.erseEy:�ffeci adJac�nt-�prop�rtie�,.the owner �n�y be'cited for v(orating
<br /> th� condllio.ns;of th� buliding':p�rrroit issu�d�under Qhe:�aE�ched pecmiQ„Appiicatlon;-for�:9ots-tess:fhan.one (1)
<br /> acP�wFiich er�eEev�ted�6y;f�ll,�n,engir�eer�d draln�ge plan i�r�qulred. •
<br /> I�I am the:A�E9V�'-�OR TH��OWINER;,I;promise.In,good.faith to inform the owner of th�perrnitQing conditlons set forth In
<br /> Qhis a�fidavit1pPior to comm�ncing cons�ruc4lon. I und�ratand thet���separate permlt may be requtred for �lectric�,l.�rork,
<br /> piumbing,..sigras, .vmeEl�,:.poots;,_air conditlo�Eng, .ga�, ��c-oth�r InstaIl�QEona noE•specpflc�lly includ�d�tn the appldcat3ore. .A
<br /> p�rrnfE Bssued s�tali be consfrued to be�e�license'�to proceed with'ttie_�iork..and_not;a�s.;authoNty::to:vio0at�;�cancel�-�Iter, or ,
<br /> s�t asid�.anjo pr�vis(ons of th�.teclinical.c�d�s;�nor shall Issuanc��of a.permit.pr���nt the Bulldirig Ofticlal frorn 4h�reafter
<br /> ,. .
<br /> requlrtn.g�caccection_a�f eRor�:irn,p9ans; conatruct0.on.oe.�lolat(ons of-�ny codes: .Ev�ay�-p�ermit�issue�shall becocne invalid
<br /> �anless the work authorized.b� �uch perm9t:�ls-comrn�nce�•�al�Foin sf�c;r�on4ha o�p��nl@ l�su�nce, or IP avArk authorized by
<br /> �he perm(t is suspended or;ahr�ndoned:for:a-„period,,o�,�Uc�,f�)Qnontiis.�f���#h��tim�the�wo�k�ls coreim�nced. Are extension
<br /> may be �equ�sted,,ln writing,�wf�orn.the Bullding,Officl�l fior � p��lod-:not-to exceed'�nf�ety'(90)�d�y� �nd-uvlll��demonstr�te
<br /> ju§tifiable°caus�for.��h�ext�nsion. If work�eases:for ninety(90)cons.�cutibe:d�y.s�..4h�job�ts consid�r�d aba�doned.
<br /> ., ..., . .... ,, :�.
<br /> �r�RNiN� T� OYVWEI�: �Q.l1�.;�AILIJRE,;TO;.��EC.O;�D.,4,�lO'�IG�:.OF��COIVBME(dCEIIAEWI':Md�Y�RESICLY�.IN YOUR
<br /> �G�IPEWG'i1AlIC�;FOR;II�APi3�OlEE16AEN�'S�;T�;:YO.UR>:P.dt�PERTY:��:I�°.XO.El�OR9'�EK�D"T�t,m�TA�N�•�It�RiE�tIVG;'CORISULT
<br /> �NBT : r . D Afd� TYO R1 Oit�+�• .Oit�t7 f��=�OU ; ; E ' `'
<br /> ., , ,;.. . , . .. .,- ... . . . ..r...-_-..�,_ _. ._ . ...
<br /> FLORIDA JIIRA'�(F.S:1.17:0 , " ,
<br /> O�UNER OR AQiE COMT(t�CT .
<br /> Sub�cribed and a to or a�irm�d)betore me thi9 Stibscribed awo �lo(ot aPflrteted)�b�Pore me'ttilg
<br /> by _ .�y_ .. . ._ , .,
<br /> �1lho is/are per�oraally,known to•me oe;ha�lhave.produced �Vho.9s/are p.er�orsaliykno�m�to:me:or haadhav��produ�ed • , -
<br /> � ae IdenUflcatl4�.�" ' as IdenBflcation.
<br /> Notery Public . � Notaey Publlc
<br /> Commisslon PJo:'• Comr�le�lon.No. �
<br /> Mame oi Notary typed,p�lnted or stampad idame oi Notary 4yped,printed or at�mped
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