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<br /> NO`TtC��F D1EED RESTRICTtANS: Tt�e under:signed under�tands°�.th�t-thi�:,p�ctmif�rnaybe,�ubJect to"d�edp r�strlctions° .
<br /> whlch�ay be��more���st�icttve�th�n Cburity gegul�t(oti�. �Th��underslgn�d�s�umes re�pcnsiblitty'for cort�plta�tici��►►ith a�iy
<br /> ' appllcable deed restrlcttons. , -
<br /> � UMLdC�NSE� CONTR�ICTORS AND CONTRA�70R�RESPCl�i�i�tLiT`iES: If the owner has��hire� � �antractor ar
<br /> confrac#ors to undert�ke v+r�rk, th�y m�y b�_r�guired��to;b�,llc�nsed in�ccorda�ce.wittt st�te.and�loc�1 re�u4atic�ns. �tf the
<br /> cc�ntractor i� na�t tice���d as r�qufred=by I�nr� �at� the �wner and:contcac�ar=�nay b��clted for a misdsrr�e�nor violatlon
<br /> under state iaw. !f the �uoora�r or Intendedx r.orntractor �re�uncertaln as to wh�t Itcenatng.rer�uirements rr��ay�appfy�r the
<br /> intended wrork,they are�dvised ta c�ntact th�,P��ca�County 8u1lding lnsp�ctlon Dtvtston--t;icensing ae�ti�n at 727-8��-
<br /> 8009. Furthennur�� t� �he owner has ht�d a contraafoc or cmritr�ctors, h� 6s aciv6�gd t� hav� the canlractor(s} sigrr
<br /> portions of the °contractor 8icrck" of this.a�pp�{catlon for vutrlah fi�ey wiilt b�,r�spotislble. tt y�,u, as.the owrier�ign ss tt�� i
<br /> cantr�ctor, �h��-�n�y be an IndE�at�on t�at�Fie is �ot.pr�p�rly licensad and is n�t entltled ta �srmltting priulleges tn P�sc� i
<br /> Co�anky.
<br /> TRANSPOltTAT1�N IMPACTIlIT1�:IT1ES`IAAP�AG714t��f�E�OURGE RE�OVERX FEES: T�he undersign�d-understar�ds
<br /> that Tr�nsportation Imp�ct Fe�s��nd R�co.urse Recov�r.y.Fees m�y appiy�t�°the con�tructi�n of n�w buildings��chang�df
<br /> use tn exisking ba�llding�, �r<expansi���of�ezi�t��i�g'�6uildings, �s �p�ci��d.in Pasco County C3idtnance number 89-�T and
<br /> g�-oT, as amended. �'he undersigned a��o_=und�rstands, #hat�such tee�,�:a�,��y_�e�d�ae;:wHl:��be identl��d at the#1me o#
<br /> perrnit8ing. ft�s fur�her underst�od th�t Tra��p�rtation lmpa+ct Fees and°Resource Rec�vei�y Fees must be pa�ld griar to
<br /> receiv�r�g a.•�ert�dcate o#�occupar�cy" or#ina! power-rglease, :{��tF�g pra�j�ct_does nat invo9v�.��.c�rtiflcate of occupancy.or �
<br /> flna! pow�r relea��. the�fe�s mu�t !ie pa(d pr.lor 4o permit I�suahce. F�tthgrmare,•�f�Pasco Caunty`1NaterlSewer lmpacf �
<br /> fe�s�re du�,they.must be pald.prior fo permit-lssuanc��ln a�cordance with�appl6cabF�P�sc��Caun#y ord�n�r�ce�. • '
<br /> �63NSTRUCTION LIEN L�►�il(Chept�r 713, Et�r�d��tatut���s amee�d��y: if valuatia��f w€�rk is$2,50�.fl�ar rr�ote� 1
<br /> certity that 1, #he appllcant, hs�t+�-been pro�tlded with � capy of �he-"Florid�--��nstrcsc44on- Ll�n l.aw=liomeown�r's
<br /> Prot�ction GuEde" preparsd by Bhe �l�rida �epartment�of�►grlcuttu�e �nd Consumer��ff�tc�. If the app!(cant l� some�ne
<br /> other than the°�wne�', !��rtl�r that l�h�ve.obtained�a c�py��f.the-above..descrlb�d docur�ent°and.pr�r�is+�in.gaod faikh tn
<br /> deliver Mt ta the.'owner"prior tc�:ccammenc�m�nt. ' - . � � _
<br /> ��MTFBA�TOR'�AOYVNE�'�AP�tCbAVIT: 1 cer�ify�.tha#_�11-th��.6nformati�n.in this�pplfc�tion is accura�t�.�nd #hat all wor�
<br /> �,�f!�be don� ir� complfiance with all appiica�le Isws regt�latirtg�o�t�#r�ctlon, zonin��nd:land�devetapmen#. App#i��ti�n is
<br /> �ereby rpaade to obtatn .� perm#t Co do_wo�4c.-.�nd Installatio€� as Indt��t�d.�- `I cert�'y that c�o work-or InstalEatton has
<br /> commenc�d prlor #a� Is�uat�ce of a perrrslt and #hat.all work wlll b�a performed�to mee# standards of �tl laws r�gula�ing-
<br /> c�anstruction, County and City cades, �oNng regulatlo.ns! and land �ev�6opment r.egul�tion� in #h� jurisdiction. 1 aiso
<br /> c�rtlfy tl�at i u�nderstend thaE the r�gulat�ons of nther gov�rnnn�nt�g�nct�s may�appiy�to th�in#�nded w�rk, and fhat it is
<br /> �;�v responsibllity#o ider�tify•whaf.ac#ions t must t�ke:to b�dt�>cor�piianc�: �uch age�ncle�lnclude but are.�ot limited ta:
<br /> - Deparfrne�t of Er�vironment�t Protectiora-C�ypr��§.-Bayhes�i3�; 1�fi�#land Area� and Envire�r�menta}ly S�r�sifiv�
<br /> Lands,WatedWasteuv�ter Tr�atrr�ent.
<br /> - �r�uthwest �lorid� W�4er Management :�istr��k V!leAs, f%YPress.` B�y�eads; V�etland Ar+�as, Altering
<br /> VUatercc�urses,
<br /> - Army Corps of Engtneers-��a�ralls,Docics, Navlgabie Wat�rw�ys.
<br /> - D�part�ent of H�alth�:� Ref�abititattve Servtcss/�nvironm�r�tat Heatth t3nit V�t�ils� Wasteverat�r Yre�finent,
<br /> , �ep#ic Taeifc�, -
<br /> - US�nvfronmental Protectlon Agattc�-Asbestos abatement.
<br /> - Federal Avlatton Authority-Rurtways.
<br /> ' i understand tFiat the folto�ring.r�strictdons apply to the us�of fl(I:•
<br /> ' - �.��e af fifl is nat a0lawed in Ftoad Zorte"V�u�ess e3cp�essiy germitted. i
<br /> � - 1f th� f�ll ma�erlal is to be u�e� I� Ffc�c�d �cs�e 'A°, jt (s und�rst�od �ha# a draina�e pfan addressEng a
<br /> °�ompensatl�g �rol�m�° v�ill b$ subml�t�d a¢ �r� cr�'�-nf�f�g �rhictt !s pregar�d by a g�fessio�a! er�gineer
<br /> #Icensed by�he-S��te of Florlda. - .
<br /> - If 1h� fill materia) ts to be us� � �i� �rt� '�' in-c��ffan-with-a p�rrltt�i �t.tild€n� using stem waQ
<br /> _ constructlon, i certify that�i(��=�e�s� o�tio;�f:��a�rir�htn th�e sfe�m�v�. -
<br /> - if fi11 enateriat Is to be used En a�y �,re�, s ce�r`���• �� ct� � s�h f� � r� �ve�rss�3� affecE adJacenf
<br /> prapsrtles. 1€use of fE�E Is fo�r�i �� aa�.,���a."�fa2� 3►��`ti.°�T� I?�C'�at"'�.�: {�'Y§'9 i2�1fY�3' t313��7��C�d fOfi YIO���iI�
<br /> the condltions of fhe bulk�irx,� ��mit #�s� cr�--�f�r #;� ��;� p�� ���on, fsar la�s less than one (3}
<br /> acre whlch are elevated by f�l,�n e���d�af�sa�g? pta�is ret�u�re�. . ..
<br /> If 1 am the AGENT�OR THE OYVNI�R, 1`��romi�s i� �f�fit4�tn irn�o�m t�� or�m�er of tt� �ertnfhting conditions s�t forth in
<br /> this affidavdt�prior to comm�ncing cortst*�.��s. i �r�tar7d �at �-saparate permIt m�y �e required for electricat work,-
<br /> p6umbing, signs, wails, pv�3s; atr coraciit�aning, 9as, as �t��� Inst�atfar�s not sp�if�al3}� lt'teluded-tn fhe apptication. .A
<br /> per�ft Issued shall be canstrusd Eo tre a !(cens�to pt�s•.�ed wlth tf�e �rk and nv#as �ut��r to vlolate� cancel, alt�r, or
<br /> set a�ide�r�y provlslons of fhe technic� co�es, nar sha�} lssu�.r�crf a permit p�evet�f fh��ulldlrig Offtc}al from thereafter
<br /> r�quiring�correction af errors In�plans; cons#ntctlfln or v'�rdatf�ns afi any cades, Every p�rmit Issued shall becam�inaalid
<br /> uni�ss th� work aaathorized by such Fermi#-is.commen�d��iti�(n s�c months of p�er�mIt€ssu�n�e. or if vvark�u�horized by
<br /> � ihe permif is�usper�dec#�or.abae�doned€or s:peritr� af s�(�} rrE�ths sfiter tha t3rne tt��s��vc�rk-is comm�ncecl. An e�er�sion
<br /> may be reqs��st�d, in vtrr8ting� from #h� �ulld(ng.O�I�EaI for a �rlc�d r��t t� excee� rti�ety�(�U) iiays a�d��ri11 demonsfrate
<br /> ' j��ski�iabl�c�us�for_�#h�exkenslor�. If work c�ases.for nfnet�(S{?)cortsecu#Ive days�_the�ob.ts.cansldet�d aba�donsd.
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<br /> '�A�WING TQ1 QIfYN�R: YOUR.�AILURE-T4.REC.O�t�1 A N�OTIGE.OF COMMENC�MBNT-MAY�RESULT IT! Yt�UR
<br /> r�AYiNf�TVVtCE Fa1R 114iPptOVEM�NTS T�YOUt�PR�OPEi�TY, iF:YO.U�ti�'�ENi3'TQ��BTAtN�P1i�i��1NG;�ON�UL�'
<br /> �1►1TH Y !i E m �t3 AN�ATTC�itN�lt� �'�R�= ECOR�3it�G'��U�' G�'tlF- � � E -� T:
<br /> =LOf2lDAJURA�'•(f.S.1l7.03f .� . . .
<br /> OWidEft OR AtiLNT CUWTRAL`TOR � �
<br /> Subscribed and swrom M(or��9rmsd)bsPore m�th{s ' Subecrl6ed�rtd'suram ta{or a�irmed)�bef�rei me ttiis
<br /> b� �bY
<br /> Wha lsJare psrsanalty knawn to.m�ar hesRtave psaduced VUt�o.tslare personatfy ks�own�ta ma or ttasfi�va prodirce� �
<br /> as IdenBflcaUon. gs�}�,�;�
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<br />� ; P�otery Publtc - 'r�..-,�ar-r�=�:�;.�ic ;
<br /> �A� d�''�F'y�� 4"w�Si:��.J��-.�01Tr•
<br /> , ��t.-*n'',Sf�.�t.�s 1;';�,1L'�:�x�k... �.,
<br /> � ,m'.':��"�ti'1CdG3!`+:�=4C°,.]f�!'�91G�!''JK�1sF.�c�R."''
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