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<br /> 3�OTiCE t}F DEEO RESTR1CTtt?�1�: 1'he unde�rslgs�ed und��t�nd��ttt�t:t�1�.,R�rmlt:may b�;sub�ect t+�"deedp�SY IG��Qf(Sp
<br /> which m�y he<rv�oro�r.estiict6ve=tt��c�Ciaranty�eig�ataHons. �1'he undersi�ned�issurrees re�piinslbiiity for camp�iance ievit6i any
<br /> appllc�ble d�+sd r��irPctlons. _ .. � �
<br /> tJRII.IC�IN��D C�NTRA�'T�RS �iND CONTRAGT�R RESP't�NSI�tL1T1E�: -�f th� m�sr has=-hir� �� c�s�tiact�r or
<br /> aantractors 4o und�rt�k�work, they may be:regufr�d,,to.:b�,llcen�ed In accordance.wdth state.and•locat regulatlons. �If tt��
<br /> con�ractor is not 1€�ets��d.a� r�qu�red�by 1aw� both the �w��s atsd coii#�actor may be�clted for a�rr�dstlemean�r v1olatlon
<br /> under stat� law. If the owner or Intee�d�d�contr�ctor �re�wncer#atn as to wh�# li�an�ing.requtrements may appty�r the
<br /> intended w�rk, th�y�re advls�#tt�c�ntact the Pasco�our�ty�uildtng'Insp��tlon Dtvlslon--Llc�nsireg S�ct6on at 727-847-
<br /> � 8009. �urthermore, if the �wn�r�fias hired�� �csrtUaator or coritractors. i�e �s advised to h�ve th�r contractc�r(s} sigra
<br /> portions of the "contr�ctor Block" of this appllcation for vuhOch they wrill be x�aspon�ible: If-you, as.the ovm�r sBgin�as th�
<br /> cont�actor, thet��may be ara indic�ti�r� #hat ii� is r�ot.prca�erly iic�n�sd anc!�1s nc�t entltled tt� pertztitting �r�v!leges !n P�sco
<br /> Gounty.
<br /> T�iAtd��ORi"�1'TtON:IMPA,GTt1lTl�:ITIES�lMPAGT�AND-I�ESAU�t�E ltECCIVERY�EES. The under�lgned�und�rstand�
<br /> that Traresport�#fon impact Fees��nd.Recourse Recover.y.Fe�s m�y.,sppiy�to�tfie c�nstruatdan a�e��w b�ildtngs,chang�of
<br /> use tn exis4ing buildings, a�r.exp�nsiorrrof:eiilstiri,g`6uildings� as �pec6fl�d.in Pascq County Ordinance number 89-07 artd
<br /> 80-07, as ��ended. �he u�der�ig��d �1s�ut�derst�nds, th�t�uch f��s�.a�<m�y�be��da�,:�wtll�be Id�nt�i�d at t�e t�m�of
<br /> p�rrnit�ing. It is fuetfier ur�d�r�to�d th�t Transport�tton Itnpact Fees attd`R�esource R�aovery Fees must be paid p�tor ta
<br /> r�c��v�n�a°certific�te of ac�upancy"_or fln�l p�w�r reiease. :!f the prtaj�ct�does not�Dnval�re.a�.certi�4c�t� of occupancy�or-�
<br /> final pouv�r relea�a, th�fees mast 6� paid pic(or ta permit issuanc�. Ft��thermora;�if Pa�c€r�C�aunty iN�t�rlSew�r lmpact
<br /> fees are due,they.tnust b�p�ld prior t�.permit�-issu�nee=ln.�ccordance with�arpplic�bie Pasco�County ordlnances. �
<br /> �ONS'TRLtCTt0�1 LIEN LAtilt(Cha�ter a13��loc�cl�St�tat�s,�ame���d}: if valuatt�a��$wor�c 3s��,500.0��r more,l
<br /> ceriify that !, the applicant,_ h�ve-b�en provlded with a copy of�the�°Florida-��onstructton� Ll�n�Law--hlomeowner's
<br /> Pt'0�8C�E0(1 Cst1I{.��" prepared by the Fiorlda �epartment�f Agricuttt�re and Consumer-A�Irs. !f the appl{cant!s sameorte
<br /> other than the"owr�er", I c�rtify that l�h�ve.obtained�a copy.of.the above.�escribed��iocurn�nt�ared.prar�ise�in:good faith t�
<br /> deliv�r It to the.'�wt��c"�prlor to�cs�mm�nc�m�nt. ' � .
<br /> �ONTR,�►�TCtR'SIOWNE�'�J�FF��?AViT: 9.cert�y�.tttat�11.the..inf.orma#lon.ln fFtl��pp1[catlon Es a�cur,at�.s�r►d fhat�1}wark
<br /> �rill�b� done in compliance with ail appllcable lawr� r�gulating �onstru�ction� xoning and�i�nd�d�vefopment. Appl(cation is
<br /> i�r�by rnade to obtal� .a perrrtit fQ do war�c.-ar�d ln�tal}aEl�n a� indl��ted.= °1 certifjd t#taf no work os Install�tiain has
<br /> comm�nced prior to fssu�nce af a p�rmit and that.all work wlll b� p�rtormed to m��# �tandards-of ali i�ws r�gulating-
<br /> �or�structlon, County and C'sky codes, zoning csgulatlo.ns, a�d tand developr�ent eagulatlens�ln th� �urdsdlctio�. l al'so
<br /> �ify #hat i uz�derst�nd th�f the regvlaflons of ather�govsr�m+ant ag�nat�s may�a�ppty�to th�ir���nd�ed work, an�that it is
<br /> r�y respansibility to identify.whatr�ctions !rptust take:to b��in:.�rrNplian�e: S.u�ch ag�ncl��i�clude but��re.not Ilmited 40:
<br /> , - 3�eparttv�ent af E�vir�nrn+snfal Protec#ion-CYpress.���yheaii�;�W�tlanti Are�s and Envit�ntnenta#Iy Sensitive
<br /> Lands,VilaterllN�stewater Tregtment.
<br /> ,.
<br /> - Sout#�west Florid� Wat�r Mattag�m�Ttt .�i5t�i�t W�1l�: Cypress. B�y_�e�ads; Wetland Areas, P�Itering
<br /> iNat�rcaurs�s.
<br /> - Army Corps af Engine��-�ea�vaUs, Docks, N�vlgatile Wat�rvvays.
<br /> - E�e�aa�rtrrtent of�Health � Rst�abl)Itat�re SetvloeslEr�viroatta�enf�l }#��Sth U'tt�t lttitell.s, 1l��ateu�rater-Trest�ner�t,
<br /> �eptic Tariks.. � _
<br /> - US Env3r�nmenta6 Protectton Ag�ettcy-Asb�stc►�abaterngr�t._ -
<br /> - F�der�al AvlaQon.Authority=Rur�rays.
<br /> i understand Qhat the f�Aowing.r��irictlons apply#�tFfe use of flII:�
<br /> • - �l��of fi11€s no#allaw►ec3 in Ftood"Zcne"�u�iess expressIy permitted.
<br /> - If the fill material Is to_be used Ia� �i Za�te `A', #E Is understo�d that a dralnag� ptan addressing a
<br /> "comperosaftng v�lut��° will ba sc�b�rtlfte�� �� �f� cs��e�s-ft�Ing w�i�ch f� prepar� �y a professlt�nal engEnee�
<br /> Ilcen�ed by the St�te of FI�r1da.
<br /> - !f th� i1ll rnaterlal Is=t� be u�ed fr� F� Z� '�' i�r�z�t�itort-with-a �ri� b�.riidin� usirtg stem wa!!
<br /> � construc4ion, t c�rtify tha#fi�l-�,�Al�b�e T:���d �-�to���-�a�i�tIae sfigri wa�i.
<br /> - if fll m�terlal (s to be used 4n ��� a�a, 1 ce�� ��` �sa. � ��.r�r � �r� �a� �dv�-�e�y a�ect adjacent
<br /> properti�s. t�use af#�i Is fa�r�cE t� �dv�-��#����� �'�-�ie�j �a �e�rrxay� b��if$�i�-v�c�Tating
<br /> the condffions af the� buildlrrg �rm� i�s�d �r�de� �.�e �,.��ci p�r�i� �p+i�a�*vr�, `a� lots (ess than ane (1)
<br /> a�cre wi�fch are elevats�€ by�!�an e:�r�-eci dr�����r�1�re�u��d.
<br /> if 1 am khe AGEN7 FOFt THE�YY�#�R, l,���S� �! �fa�v`t f� k�so�rn� the a�ina�a#th�e p�e�ntlftlr�g condit�ons seE forth in
<br /> this af6idavit'parlor to cvmrt�enci�g ca�tstru�o�t. ! u�r=��rs#a�rr� that a-separate petvnlf may b�e reyutred for electrlcsl work,
<br /> pJ�arnbing, signs, well�, poals, aIr ca�tdlt�r}rtirt�,.�as, � crt�� fr���#ati+�ns rtc�� sp�a�if�+E}y irt�Euded-In.#t7e application. .A
<br /> perrnit Issued shall be cortstrued to b� � license fv �a�cea�r�it� tfi�e�c and not as �utharity #o,vtolate,cance4, alter, or
<br /> set aside arty pr$vis{ans o€ttia.#echnk� co�e�, nor sh�f Iss�ar�e o#a perrnit p�e�e�#tt��utldirig Ufficiai fram thereafter �
<br /> requiring�correctinn af ercors in p1a�s; constructlon or v�al�tFons c�f any cod�s. Every p�rrnit tsscred shail become invalid
<br /> �niess th�wark authorized-by such p�rmit-ls-comm�n�+c! �r1[�t�n sfx rnonths of permit Issuance, or if vvark autharized by
<br /> the permit is st�spend�d ar.�bandoned far�per�od of sb�f8) mo�t�s aft�r the#lrne t3�a�nrrsrk-�s comm�nced. A�ex�enston
<br /> may be request�d� In writing, from the Building.Offi�lal for a p��i�ad rtat to exc�ed n{i��jr�(g0)�days a�d vvltl demonstrate
<br /> ;�rski�ab9e�aus�for.•the extensio�: If work ceases.for n(n�ty(�Q}corts�cu#1ve day_s,_ths�ob�Is_consldered�bandoned.
<br /> - � � . � . .
<br /> �JAFtNlNC TCl OWN�R; YOUR..FAIL.URE,T�.R�C.OEiD A IVC?T1G� OF COMMENCEMEMT�MAY�RESULT IN Y�tJR
<br /> �AY1NC�'fVViCE��R 1141#P�OVEMEi`iTS Tti YQUI�<PRpPER�'FY. 1��.Y�.U-1t+�"FEND'TQ'CiBTAIN�EIMRt�E1NG;�C.t�HSULT
<br /> 9NITH�Y UR D :O AN��TTORNEY� FARI� E�OR� G=`�'�JtD � �'O : Q E �N�1 T'
<br /> =L4RItP�1 JURA'fi°�(F.S:1.1T.Q3} •_ . _
<br /> stWNEfR OR AC#ENT CONYR�#GTO
<br /> Subsafbed and swom to(or�#Artned}betare r�e lhSs Sabscrtbed and'swa 'M(at a rmedpbefore ro+� � _
<br /> bY •by - -
<br /> Who ts/are personslly knaum to.me or_h��lhave produced Who.l�/�re personaliy knawn�to me ar heslt�ave-prod� f
<br />, as IdenBftca�on. as i���lkx�. ,
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<br /> htoffiryt�ttblta _ �,,�;�,�.
<br /> �.���+-tic.• Cyz-�:kf�,���,
<br /> �;���=�P.•;:�..�a;�#ec�-s�,:�-.� '�'�-����°,t�.;�rs����c
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