�d�`1�+�E QF DEE�R��Y1�1C�'I��i�: The u�det�ig�ed under�tand�°=.th�t:ttals.p�rmlt.may,b�,,subJe��to"deed"re�trf�tlon�"
<br /> which may�be<more:re�t�tct(ve.th��Cour�ty<�r�g�alatCons: �The�underaigned�'sissurr'ies'�es�orasibillty for"cci�riplian�e veiQM any
<br /> appllcable'deed eestri�tlons. .
<br /> 4fN1.tCE�l3ED CO�i�'RACTt�R� d0.ND CONTiR�►C'TUR R�S4�ON�1�{L6�E�: If the �wn�r fi�� hir�d a �ar�trac��r or
<br /> cor►tractvrs to a�ndertake work, th�y rraay be;cequiced.�t�a-:b�.:Mt�ensed In accordanc�.wlth state.and•local regulati¢�ns. If the
<br /> c�ntr�ct�r ts not ticensed-as�raq�Ored'-by I�w, bo�#he ouvn�r�nd con�ractor°niay #e°cl#ed-for a�mi�t�ermear�or v�miation
<br /> und�r state iaw. If the owner or Intended.�_contractor �r�.uneertaln as to what Ilce�rs�ing.r�equlrements m�y.-apply,�'or the
<br /> intended woPk,th�y are advls�d t�coret�ct the P'asco Got�rat�t Sulliding`In�pecttain Dlvlslan—Ldcenstng Sectton�t 727-847-
<br /> 5�08. Furthermore, if the c+wneP t�a� htPed � core�rac#or c�r contractors, he is acivised #o have the cantractor(sD, sign
<br /> portic►ns af 4he �contPactor BlockW af thfs appllc��lon far whl�h 4hey wiEl be.re�ponstble.. If.you, as.the owri�c sign��is'th�
<br /> �ortt�ac��r, that�m�y be ar� indicatlan th�#�h� i� e�ot.prop�rly licens�d and��ls c�e�#entit��d #o p�rri�itting p�hrl3eges tn PascQ
<br /> Cowr�ty.
<br /> 'Ti�#td�P�ItTA7lON�IMPAC�'P4DYY�:�'Q'mES�lNlPA�Y'A�1b RE�0�9RC��E�O�'ERY��EES; The�nd�s�9gned under�4�nds
<br /> tha�'Pran�por�atlon �mpact�ees and.Reca��rse Recove�gr.F�es r�ay�:�pply tc�ttae construc�ion of�ew buliding���ch�r+�e°of
<br /> use in �xisting buildings, or e�xp�rosi�n�of-��eulskir�,g<buililings, as spectfl�d.In Pasco Caunty Ordir�ance raumber 89-07 and
<br /> 90-43T, as amended. The �nde�l�ned �Iso.�nder�#a�ds; thai�:�such�ees,�:�s�may:be�due;�will:r6e Ider�4lEied at Qhe time°of
<br /> perrnitti�g. It Is fu�tFier understood that Transportatian Impao�'Fees �nd�Resowrc� Recovery{Fees mus# be paid pP9ar ta
<br /> ee�elvirag a°ce�Ebficate of occupa��y°' or�inai powe.r..releas�. :4��the projc�ct;.d�� n�t fnvoiv�a.cer4i�c�te of acca�par�cy or
<br /> final power ret��s�;-the fees rnusQ be pattl prior#o perm6t issuance. FulGthermare;1f Pasco �ounty VV�ter/Sew►�r Irrtnpact
<br /> fees are due,.they�rrwst be..pald.pN�c�to p�rmiE•i�suance�ln accoed�,nr.��rlth�applloabl�Pasao'.C�unty ordinances. �
<br /> C�Bd�TRUGTI�IN�.lEP!�1�it{Gli��ptee 71�� �In+rlil����ta�t+��;�rs asr��n+���1�: If v��t�atlor�of work is 52,500.00�or mare, i
<br /> cerkify that I, Qhe ap�licant, h�v�.been provtded v�tith � copy of th� wFlorida Canstruction Li�n L�v�►—Harneov�ner's
<br /> Protectton Guide" pe�p�red by�t� Fiotida �ep�rQt4tent of Agri�uEture �nd +Con�t�tr�er A�atrs. If#he �pp�ica�tQ Is svrraeone
<br /> �ther than#he"owner", I certify that i h�v�,o�itailn�d�a copy;oP.the-�bmve..�tescri�edd�curi�ent=and.ptomise in,good f�i�h to
<br /> del6ver it ta th�"own��'�prior�to:covnpn�ncernen�:'
<br /> C�N�CT�iR'S/O�NER��AF�I�AYIT: 9.c�rt�ty,..that>a11.th���ir�fc�ran�ti�►r�:ic�thl�appitc�tEan is accu��e$nd that ali work
<br /> will'b� done in campliarrce wlQh all �ppltcabl� laws regul�ting co�strucQlan, zoning and:�land developm�nt. Appitcat9on is
<br /> �ereby enade ta obtaln .a permit 4a-do.war�.,.a�ed I�staHaticen �� ind[��t�d: '# ce�ttfy that no work�e�r Ins#altatton 9�as
<br /> �omrnenced pri�r to Issuan�e of a, permlt and that.all work will be perfarmed to rro�aet st�ndards of a�ll laws regulating�
<br /> constr�ctlon, County �nd City c�d�s+ zoning regulatl�ns, a�nd land development regalattans�in Qhe �urlsdic�lon. i alsc�
<br /> ���tify�ha�t 1 ur�derstand that fhe regu6�tlons of�Qher g�vernm�nt�agencies may�appiy�f�the int��ded v�rork, and tha# it is
<br /> my r�sponsibility to ident(fy�wh�t,a�tB�ns I mu�t tak�.M be,In;.au�pl0ance: S.uch�gencie�Include bw�are.not Iimiked ta:
<br /> - Departrn�n� af �t�vir�e�rm�ntal�F�ro#ectlon•"CYP�e�s.�ayhe�d�, lNe�lend Are�� and Envlrorarrnentally S�n�3tive
<br /> Lands,iNat�rMlast�w�t�sr T'�atment.
<br /> - Svuthw�st Fl�r�da 1(��ter �!lanagement: .QisU1�4-We!!s, C%YRr�ss.'.`Bayheads; Wetl�nd A���, AI#�r3ng
<br /> Wa#er�ouPses.
<br /> - Army Corps of EPtgine�rs-Se�w�lls, Dock�, ll�avigable V1laterw��s.
<br /> - �epartcnent of Health�& Ret��t�ltlta4�ve Secvi�eslEnvitonmee��a1 Heal#h 1�ln��Vells� 1lVaste�vu�ter-Treatnnent,
<br /> 3ep41�Tanics. _
<br /> - US E�v�ro�►me�t�0�r�teoti�n Ager�cy Asb�stos�bat�menQ.
<br /> - Federal Aviation.Authoriiy-Ru�wr�yse
<br /> I understand tha�the falOowing.�restrl�4ions apply to dhe use of flll:•
<br /> - Use of�ill is not aolowed in Flood�ane��1"unless expre�sly per�itted.
<br /> - If the fill �naterial is t� bs used.l�.�Flood Zoneo. "A", It. is uraderstood that a dr�ine�g� �la� address(ng a
<br /> "compe��a�in�vol�rrpe"wilt be subml�ted at�ime o�:permi�irtg t�hich 1� ptepa�ed by � profess�anat �n�Eneer
<br /> licer�sed by�he Sta4e of'Florld�:
<br /> - 9f 4h� fill matertal ts to.be used 6n Fiood Zon� "A" tn!�onn�clion�with�a p�rmitted ba�ilding �sing �4errt wrall
<br /> � constt�c#Dan, E c�r#iiy th�t�Il:w�ll�b�t�sed o�ly.#o fi�tl tFr�are�wlthin the�stetm�w�9{.
<br /> - If fi10 m�teri�l Is 4o be used in any area, I cer#Ifyr that us�. of such fll9 w�ill not advers�0y affect adjacent
<br /> �ropertfes. If u�e of f��13s fo�etd to �dvers��y:�ff�ct adJs+�nt�p�opertl���.#h�owtnee may be ci#ed f�r vio9�ting
<br /> the conditions of the buiiding:p�rmit Issued uroder the �t��ched permit applicatlan, far lots less than or�e� (1)
<br /> acrs uvhtch are ele�ated�by�4!!,��engln�ered dr�lnage pia�fs required.
<br /> if 6 am the mGEMT FOi�TH��WFOER, I;prorvtiae In gcaod fat#h to infarm tlhe owner of-#he p�rtnittir�g conditdons se�foa#h in
<br /> this affid�vtk'prior to camrraeractng �ons�ru�tlon. I und�r�taeod thet�a�separat� permit rr�ay be requlred for�le�trical uvork.
<br /> ptu�nbing, signs, w�11s�.poa�s; alr c�ndltic►�I�g,.g�s��or �tt�ee insfa@I�tians no�.sp���fEcally Onciuded-�n.�tte applicatian. .A
<br /> permlt Ossued shall be cmns4nued#o be a�If�ensd�o praceed with !he wor�and not as.authority to.violate, cancei, altea�, or
<br /> set a�slde acty pro�tis[�n�of 4h$fiechnqc�!ct9de§; r�o�shall lssuancs�of a�ert�tt prevent th��uildlrig�iclal from therea�ker
<br /> requ0r€ng a corra�tion af errors ir�ptans; construc�ion or vialaQions of any cod�s. Every-p�ermit Ossued sfiail become inwalld
<br /> unl�ss 4he work authortzed by such permlt:ls.cocr�menced�wlthln sGc mgn4h� of�permik Issuance. a�r if vvork.,authmrized by
<br /> �he per�it is�uspe�d�d ar.aband�n�d-for a:�erlad of�I�{8}un�t�t�s.�ftec t�e#Ime#he'wo�Oc is cammec�ced. Ar�e3c#en�ian
<br /> may be requested, in w�lting, from th��Building,Clfflcial for a p�riod.not ta exc�ed nir�ty(90) d�ys and-wrill demon�Qrate
<br /> justifiable cause for.the exten�#on: ��tRiO!}t C88lSSS:fQf/tlPi@�f,tgQ}C�ftS.�G�lt�Y@�8jt&,.-the job��s consfder�d aba�doned.
<br /> VNARNBNG TO CM1RIfdIE�t: YCM�J�._FAILUR��TO..REC.C1�iD A.RDOTIGE���� COBI�MEMCE19AfEMT III�Y I�E�UI:T IN�Y�►UR
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<br /> Subscdbed and swom to( r rm d)befor�m thl� Subscrlbed and' �QQ(at afl}mted)' for�eti�'fttl�
<br /> la-r�-r�r ;��� �. rn r�,��- - - � tnt �
<br /> Who is/ar on nnv�db.m�or.hasJh�a�produced Who is/are . onel � me or has/�ha�ve�produced
<br /> as Id�ntl�cetlpn, as ldentlflcallon.
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<br /> ,.,.;��rpU`�, SYCVIAA.CAMPBELt.
<br /> sa°. ;'o`: NotaryPublic-Stateo►Flarida SYLV�AA.CAMPBELL
<br /> Name oI Notary QT sta s�on Name aP Notery 4ype �a �
<br /> �� 9�;: My Comm.Expires 1ui 14,2021 = * *.; Commission#GG t 12939
<br /> '�`�,°FftO¢�`' gondedthraughNakionalNolaryAssn. �s� e� MyComm.Expires1a119�20�1
<br /> ��, HandedthroughNationalNotacyAssn.
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