��`�BC�t1F�EEQ��S'�R��T����. The��d�r�lgr��d ci�d�E�r;td�F�t1t�#:#�a1.�,p�cr.n�iE�.o�,ay<:be,sub�ec�,f�ad,+�ed"..resEctcNa�t�s°� „ . ,.
<br /> which ma f be,m�ro'^r�siF�ct9������c��Coun ���r� a�l��lon's:�'�'Fie und�r�igned�r�s�um�s=�e� onslbilt �far�cor�� 19ariici�wit�"aei .
<br /> y tj►� �g P h+� P Y
<br /> appllvable d�ed ro�trlcttons. ,...= 4 .. . . :. �,
<br /> tJt�L,ICEF��ED-�COt�'1'�G�CIRS �k�� �CtJ41�l�C'�I� Q���P�N�1�1�1'Q���: =�f�t$�e-�wn���h�sr`i�i�d•���:c�iirotr�o��r or
<br /> con#ractors 4o und�r��ke wo�k, thay mey:lbe.�req�rlr�ed:ta:be�la��ns�d in.a�rda�c�.with stat�.and;9ac�l;�eguiatl.a,ns.�+If`the•, : =;"
<br /> contractor 6s �ot �Ic�ns�d a�s�r�qtalr�d�:by �atir,:boQh #h� ov�er ar�i!+c�iiih�c¢�rhms�y be���lt�d'f�r•���oflt���mean�r v��l�f1�n
<br />' und�r s2ate law, If the owrner or i�t4ended;.�cont�'a.c,tor,�,ar.e;;uncertaln as t�wha� It�enaing,-requlreFnenQs prmay-appey�::for.�°the° � -- �
<br /> 6�i�r�ded work,they�re�acivl�e�ta�ati#act ttie��asc��Caunty,�ulldl��'t��p�ct6on,D(vl�ion-�lcen�ing Sectlon�$��7-�47-
<br /> ��09. Furtherrnoe�, tf the oau�er Fa�s"hie�i! � coitti�ctibr oP coritt�s��rs, he is advts�d t� hsve �th� cantractor(sq,.sign . -
<br /> pork9ans of the "csentractmr Blook" of,this,�applics�tic�n..for.,vuhich..they wrlll b�n..r.esponslble.-„tf:.yau;=��=.th� �i"virne�'`stgn'rai�'�th�'`` '
<br /> coe�4ra�t�r, ths�-rnay 6� �n indic�ticrn �h�t�ti� is e��t�:�roperly Ilc�nse� a�+d'��"�iat�rit�t�� � p�r�i4�ing �riullegeis in P�sco _
<br /> County. : ; �- , .
<br /> '��I�SPC�RT�►TQC?N-lMPACTII➢�'9�:��'lE��C�lPI4G'9�d�NC?°l�1E��URGE RE�+�V��Y�FEE�.� Yhe��nderslg�ied-uride���nds
<br /> �hat Transparf�tian impact F�es�nd.R�c�out��.Rec�v+�ey.Fees m's,�.�pp1y�.�t��ti►e��onstrvc#tan�f e�ew.buildings„�chan�e�=af'�`� `��" �
<br /> use in exi�ti�� ba�ildings, or°_���par�'sitirr�of-•sexi�ti�i�.�builtltngs, �� sp�olfled.It� Pasc� Cr�tanty Ordina�r�ce nu�mber�9-07 �nd
<br /> ��-g7, a��mend�d.,,u.'i�h� und,��g�ed a0�o=����rst�rids, �li�t:�such f��s;�;�s��nay�ti��cl�ae;:;=�nr111;}be id�ri@�Fted at thertimet�f�,.� �', �
<br /> permittBng. It Is lurther understood thaQ Tr�anspoctation Ompa��"�e�� ared`xResource:;Ff�covery�F�es,.rrau'�t be p�id p�lar to
<br /> _ . .._
<br /> cece�vin�-�."r.e�lffc�t�.a��accupa�o�yy"o�fln�l�t�wer>.r�l�e��g: :8f Eh�.p�a��Q::do�s.not In�oive�ar�ert�ic�Ce� e�f occupan��t�orY==�'=°� , °
<br /> final p�w�r rete�s�; the f��s mu�t"t��"paia,pci��to..pertnft i��taa%ic�. �t,�t�i�rnnor�;��if:Pas�;Counkyr�Vl�at�rlSew�r..a:Ompact � - � �
<br /> fe�s are due�_they:.rnust.b�=paid:pilor to_permlt;I��U�►nc��.ln�coord�nce a►ttFi�apPllcable:P�sca'��Couc�ty�orcilnance�. -
<br /> ��NST��l�TI�N���EPi"�A�V(�le�g�ter 7�9:�� ��sta��al��tatute����tme�d��j: tf v�luz�tl�n c�t'w�rk is�2rSOQ.00�or-�ramre,.3 �.
<br /> certify that I, �h�: �pplic�nt, -h�v� be�n�.p'o�rided�wtth�a-c�py of �4he '"F9or3d�•-ConsteucNan� Llen L�w—Hom�owner's
<br /> �roteat��n G�3dep pr�pared by Q1i��FEo�da�1ep�rtmenQ�af Agr�c�ltur��nd �o��umer..Affalr�. If t1�e ��plican#I� �omegn� .
<br /> other thae�#he"c�ner", i certifyr�hat.,9�h�ve.ob,taln�d='�=`��y;�fi:�h���bo�e:,��s�ri��d�iocu�ent°and;.pror�is�;.(n,g�od:_�aith�to
<br /> d�liv�r IQ Ea th�°owaiec".pi�or�ta�incomritencern�nt:� . � .
<br /> �ONV�+�'TOR'�t�aCtPlER'��FFO�►�lYl�': i.c_e,�tify=.ti�at�1i..th+�xi�foct��fltm.in-tha��ppllc�tt�n is�ccur�t�.�nd th�t�it wark
<br /> will'b� done in campliartc� wlQh �9G.�ppiicable lavus regul�tin� conslructlan, zon6ng and��l�nd°d�velapm�nt. Applic�tian is
<br /> hereby r�ade 40 obt�tn .a p�cm�t<fto=do-'a�tor,9c:�;and;-In�tal6�tictr� a� iridlcat�d..�.�1 ce�fify th�t n� work�or In�taltatloi� has
<br /> comnn�nc�d p�iar to Is�uanc� of�� permit���d �hat.all work wlll be p�r#a�rr��d�to me�t st�r�dard��o� �lo iaws regul�a�ing-
<br /> consb�uctlan, Coun�r and C�ly codes, zoning r�gul��t�n�, ac�d land dgv�l�pmer�t r�ga�latlen��tn th��carfsdl�t4p�: ! �lso
<br /> c��tify th�t I u�derst�nd th�a th�r�gulatior��af�ther gov�c�m���t�g�ncE�s �nay��ppiy�t�th� in�end�d w�rk, an�th�k it ls
<br /> my r��ponsibility to identffy•whet�cti�n�I rrau�t-t�ke:to be�qn:.�o�lpllanc�,..�uch,a�gencles ln�lude bwt-aP�.n�st limited 4c�: �
<br /> - �3epartrrmen� of E��1�o�ment�l='1?rot�cfto��CYp�s��.��ayhead�, �eN�ind Aa��a� and Envlronmentatly Sensttive
<br /> Lands,�lat�rMlaste�k�r Tres�@men�. �
<br /> - Southw��t Flortda MP�ter Mar�agem�n��.DlstrPct Weids, Ca+P�es�.'.B�yh��d�; VN�41anc4" Ar�a�, Alt�ring
<br /> Watercourses. •
<br /> - Army Co�ps of�ngtne��saS�awalls�C1�cks,Nadig�til�Wat�nw�ys.
<br /> - Depactrt�ee�t of Hea1Qh:'�e..R�t��lslltt�#dv�:S.�rvi�esl�c�viCta�me�ttt�6. M��Ith tl�tit�!{t�ll•;�1iit�t�v�f�r�Trea#ment,
<br /> Septic Tan9cs:. � .
<br /> • t�S Envic�nmentaa Protect�on Ageaic�-Asb�stos�b�t�meni.
<br /> Fed�ral Avleti�n_�,utho�ity-:fZunanreys.
<br /> !unde�stand Qhat the-fe�Uawln�g.:reste6ctions�pply`t�fhe use of flll:�
<br /> - Use+�f flH��not al�aw�d in:F1ood;Zone°'�`°�anEe�s express�y per�eltterd.
<br /> ' - li th�-fiil mat�rial is ta�b.e a�sed:,in �Flo�d Zone. "A"o Ik. Is under�t�od 4hat � dralnage pl�n addres�6ng �
<br /> °comp�ns�#ing volum�"w111 be sa�b�ltted �t�ime��perr���0�g�rlifch 1� prep�r�d b� � pr�f��sior��� engir�eer
<br /> Itc�nsed by#h��State of��iorld�: -
<br /> � - !f th� flll materlal�.ts t�.be a���d In F�mod �on� `A" In4 c�nn���(en�wlth:� p�rtnitted btaildl�ag using s#ern watl
<br /> � � �onstru��E�n, l certify th�t fi11:�r�tl:b.�us�d only.#o.fiit the s�re�withln�the�s#etn�A. .
<br /> - If flll ms�terial is to be used in �ny �rea, I ce�tif�r that .u��, �f �u�ch flll wlll n�t adv��aPs�ly afl'ec4 adj�cent
<br /> prapert6e�. If us�of fll� 1�fo�nd ta adve�sely..�f��c��dj��r�t�:prop�rtEe�,.th��n�r m�y b�ct#sd f�r vlo�at�ng.
<br /> th� ��ndl4lons.of Qite bulldtng;perr�ii� 1�"sued�under the �E�ach�d.permit �pplicatlan, f�r:lots less th�n o►�e (1)
<br /> �GPB W�t�CF9 E9f�BI�Y�tB��B��t�JDI,��t�rtgine�r�d dr�Qnag�pla�a fs r�qulced.
<br /> Bf 6 am th��GENT��it'iH�Cai�VNER, I��irromlae dn go+�d f�i�h��iniorm the a��r of•#h�p�rmitting canditdons set forEF�in
<br /> this ai�dabtt'pnor t�.commenain� cc�ristruct9on. I uc�ale�rstand t��t a��par�Qe permit may �� requlr�ad fe�r electrical'wark�
<br /> pl�mb6ng, sig�s, wells,.po�l�;, adr eonditla�n3ng�._g�s,.or. ot��r In�#aill�ttores t���.spe��flcs�lly incle�d�d-tn tP�e ap�llc�tton. .A
<br /> permit lssued shali b�canstru�d to be�a�Ita;�ense'•to-p�c�e�d with the�rork and na�t��s.�uthoNiy-to,vloB�t���a�nce9, �9t�r, or
<br /> ' se6�►sld�arry pm�ists�n�c�f the f�c�t�lca4.�d�s;�nor sh�i!lsst��t���c�f a.perm6t.prev�nt the Ba�IPdir�g d'�ci�l from ther�aft�r
<br /> requirEng a�ocr�ction af�re�r�9��.pB�ros;�car�s#Paicti�c�ar.viot��+�n�of-any c++a�d��. Every�-p�rn�tt�igs�ed"sh�iF�beccan��in�aiid
<br /> un9esa the wrork�uthoNzed.by such perrr�lt:�s_c�aaimenc�d�vv6Q�(n s�c m.o�ths of permit i�ssuance. ar if wa�k aukhmrized by
<br /> i �he�ermit�i�suspend�d a�:�6�e�doc�erd�fc�r.:�`;p��E�d;of���:{�}irRo�itF��.at��r.t6a�.tlrtie_t�e�w��lc��s cainmertced. A�exte�st�n
<br /> may be reque�ted, tn vuritirig,;�itom tiie,�Bulldin�,t3ffici�) for a p�r(od�not--to�xceed`�n(n±��ty(90)`days and�will d�monsQr�te
<br /> I �tisti�able�ausa for.lhg�xtenslo�: if�ark ceas�s:�or nlrtet�r.(9�p cat�s.ecu�lv�days�..the 1ab�9s conside��d a�a�d�ned.
<br /> �iYARN9f�G TO C11aVNER: Y�dJ1�..�flILIJRE,T�:,;R�C.C1EiQ,A:-I�O�'IC��:OF;•CONIMEI�C�IlAE�lT��ii'AY�iBE�ULT��IN YQ61R
<br /> P�Y1B+lG TWICE;FtDR:iM�QV'�1410E0+1��.T�t�`�E�3U�P#�QPER-`�'"l:��I�rYO.U;IlI�'#`E�1�'�TQ����'�1�11N��IQet����N�;�t)WSUl�T
<br /> �lIST di �'T�► N l�8'RE� -O � �#. �� :�: ;:. :< : � �
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<br /> �LORlt?A 3l1FTAT-{¢.�:'@. . �- -1 ' , — - --— __ z �'� _ .
<br /> �r�- �,
<br /> OVQlPI��OR AC3ENY ' '�,�� CON7'l8�CT0
<br /> Subsaihad and savflm to or�Cflrtned)betor�me Stibecrlbed'and'�+w�m�M(ot aflirtneda't�Por�►ne' �1
<br /> i by .�y.. • -- �
<br /> � Wtio i�lare per�onally�nowm�a.me or;hasffs�ve produc� VNho.l�/eP�p.ersonelly�Cnow�•td:.m�:or he�lhae�•produced •
<br /> ae Id�ntl�c�tlari, �$id�►an�a�n.
<br /> � Plcfeiry Pubttc . � Not�ry Publtc
<br /> Comml�slon Na:; �omr�Isslon No
<br /> � .
<br /> Name af NoQary typed,prinQ�d ar stampad Name oP 9Jotary 4yped,pr�n4�d ar�tamped
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