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�iCD'£8C�OF��EP�63�5�'�l�gl�&�S: Th�und�rslgnsd undat8t�nds�th�t ih1�.p�rmi�rn�ay.hasubJect to`deed"restrictlons°
<br /> v�h�oh may bs rs2ars.Cesfsictive th�n Gouniy reg�tattan�,�uisd�igned s�autn�s ees�n�Ib]#f#y far ct►sezpltanc�wtih aciy
<br /> appllcs�bfe de�d resG�cfions.
<br /> �6�4R.I�E�6�� �O�VTR61�"g'�Pt�:f�C��1 ���9T&�ki�l"CE��R��P06d�1�B�6k d C��: I�i�ts ovdner hes hired a contr�ator or
<br /> contraotors#a undastaks wortc,fhey snap bs reqs�lead E�6e<Iicens�d ic�ac�rder��.�vtt3�slsfe.�nd:tocat ceg�al�tions. di the
<br /> contran8or t3 nof llcensed�s requi�ad�by law, trath ttse owrnar and contPactor m�y bo�cite�Por�mtadamesnor vialafion
<br /> undar ctate la�r. IP'the owrnar or Intendod�crontractor ere•unoeetaln eo to what Itceneing.rcaqulrements may�ppiy ior the
<br /> Intend��u+ortc,th�y are sdvised to corilact ihe Pasco Couraty�u#fding Insp�ctiors C�Iv1slo�—LRcensing�sctlan$t 727-847-
<br /> 800�. Furtheemore, (f the owner has hir�d a coitiractar o�'c�n#�ctors, h� is edvise� to have the c4ntr�cctor�s} si�n
<br /> portlons of the"cont�actor�lock°af thle appticatlon for wrhich th�y�+lil bo r�sponslbte..�If ya�u,-as.tFra o�mer eign e�the ,
<br /> coniractor,f4�st�ma}r bo an kndicatlon thst tse Is nak�rogerly Iicenaszi and is nat�ntitiad to pernilftli►g prFvllageQ in Pasco
<br /> Cnunty.
<br /> Tl�dtd��O��Y�,Yl1�k�IE�t�7��FlLlTEl.6°CI��C�dd�'AC�'`�dF�b•F�IES�UttC�Fi��d�i��EzY-��Pe�: "f�e�ando�tgned unders�nds
<br /> tha�T�nsparta8on tmp�ct Ps3s,and.Recaurse Recovmy.Fees majrapply to ths conahvction of new bulidfngs,�hange of
<br /> usg�n a�sting buitdings,ar axpansttsrt of e�i�tiri,g'�uHdings,��$����t�a.��,����o c����,ar����c�►►u��er as-ot an�
<br /> 90-07,as emended. The underalgn�:d�Iso under�tamds,th�4 auch fea"s,.�s�may_ba dae,.wHl be trt�niified at the ttme of
<br /> parmi�tina. It Is turther undaretoad 4h�t Tr��sportaNnn Imp�ct Pees and'Resourc�Recovery'P�es must bo paid priar to
<br /> recaivEng a°cerfi#tcat�ag occupancy°or 4(nal p�rer.:re}��se. :S€�he gra3scf.dr�n�t4-invaSve a ccarttfTcate af occugancy or
<br /> £n�l powes eslease,tho fees must b�patd prior to parmi4lssuenco. F�termore;it.Pasco County tNaEerlSewor Impact
<br /> fie�s aro due,thay.must b�paid-pelor to permit Issuance in�ccordana�with applicablm Pasco Caunty ordinances. �
<br /> �OCd�'E�t3��6�F�L1�F��..AAYt�(�6�ag�8er�9a,�Ecrld�t�e�tt�$�ss.�as�traa�sd���: i�vatuatlon of vrork Is�2,540.00 or mare,!
<br /> cert(fy tha4 I, Yhe �pplicant, have•bsen provided with a copy of fhe�°Ftorida Canstruotton-llen Law—t-lomeo�vner's
<br /> P�otectlon Guid�°prepared by the Florida Depertmc�nt of Agriculture�nd Consumer Affairs. If the appltcant Is someone
<br /> othsr ihan the"aumat",!a�rtlfy that i have.ohtalned a copy of.f�s above.described-�toa�sment°and.prQmis�In good fa{th to
<br /> doHver It tn the"awnar`prior to-commencement.
<br /> GOR1�C'POR'�l�tlYt�EE�'9 A�FIClAVIT; i�rtffy ttiat all ths Infrormation,in thls applicatton is accurate and thet ail work
<br /> sv211 b�dons in ccampriar�ce wittr a11 anpllr.able laws reguisting con�UucBon,�onln�and land develapment. App!!:aUon ls
<br /> iasreby mada to obtain.a.permit #o do work and instalfatton as indEcaf'ed.� '1 cartiiy fhst no work ar 3nstslia#ton has
<br /> commena�d prior to Issuance af a permit and thak.all work will bo performad to meet standarde of alt taws regulaGng�
<br /> canstructlon, Gounky and City cvdes, zonfng rsgalations, and land dev�lopmeni regufallons�tn the Jurlsdlcklon. 1 aisa
<br /> ee;��thaf 1 understand i�af th=regutattans of a#hefgavertamsnt ag�nciAs e�ay•aPply#a th�Int�nded watk,�nd that 3t Is
<br /> mV resPonsibility to tdentify�wh�t actions I must�take to bedn-camRl►�znce: S,uah ag�ncles inafude buf ara not Ilmit�d to:
<br /> - Depart+nenk of Environrnantal l�vtectlon-Gyprmss.��yhesds,WeUand�4reas and Envfronm�nt�fly Sensi2ive
<br /> Lande,VYateriWsstewafer`�reatmen#.
<br /> � - Southwast Florida Water Management :Disfrict-VVells, Cypres.s.�Bayheads, Wettand Areas, Aitering
<br /> Watercaurses.
<br /> - Army Corps of EnoSr�sers-Seawalls,Dacks,�Eavlgabls VI(ats�+ay�.
<br /> - Dep�rtment af h4��.lth � Rehabilffative �ervtces/EnvironmenEal Nsa3th Urtlt We11s, Wastowater mreatmertf,
<br /> 5eptic Tariks. .
<br /> - llS Envimnmentei Protec#lon Agsncy-Aabes#os abatems.nt.
<br /> - Fede�ai Avtaticn Auiharity-Runwsys.
<br /> i_�nderstand that the follovrf�g.reslriations app{y to thg uso of flli:�
<br /> - L+se of fiil ls not ait�rsd fn F3ood Zone"V'untess e�ressly psrmltted.
<br /> - if ths i51f matstial is fo be ased in FIcod Zana 'A, i: (s undersfoc�d tt�at a dralnsa� plan addressing a
<br /> "compaFlsating volume"will b�subnlft=d et Lt-n�o`p�,�tt��g which is p�epa;ed by a profess1an21 engineer
<br /> licensed by tfi�e State at FlQri�a. -
<br /> - if tha fill materi3l is fo 6e vsed in Floed Zo„»',�'i,s r,����c�on-t�3ttt��atmitted bu3ldlnQ using stem wall
<br /> constructlon,i cartify that f€Il-avl;l:L�us�i onhj to fii#,'�a�,�a vrithin the siem w�11.
<br /> - If flll mate�al is to be used !n arry a�ez, i ceri�r �rr-_'E uss of such ft'd �°dIl not adversely 2fFect adJacent
<br /> propartlss. l�use of fllI�s found ta adver�fiy.a�ew�cfGceat�rop�rtiss,ti��ovrnsr may be clfsd for v{oTating
<br /> the cnndtlions af;he buiidirrg p�smit Iss�ed undsr t��aF2ched patmiF 2pp{icaUon,for lots iess than one{1)
<br /> zcre whi�h are elevated by fiIl,an srgineersd dr�lne�=ptan is raqulred. -
<br /> 1f i am the 1L��td1'FOR'ft�E gY�iER,i�gromt�e Sn goad#21fh to tnror�the oxmsr af fha gertrairiing cond�llans set farth!n
<br /> (his alfidavit�prior to comrnsncing cortstruatlan t understand that a•separate permlk may bo required for elecfrical work,
<br /> �lumbing, eigns,wells, poofs, alr cond(6oning,.gas, or other InsNallations not_spec►flcafly included�in.the appiication. A
<br /> �ermkt 1ssu�d shatt be canstrcsa�to�e a lieens�to pracsed vrlth the work and not�s authar�ty ta.violata,eane�i,atter,nr
<br /> set 2side ar�y provisions of tha technfcs}codes,nor shal(tssuanca af a permlt prev�nt tha�uitcfirig t?fflctst from thsreafter
<br /> r�quiring a correctian af errors in plans,canstruotion or violaQorts of any codes. Every p�rmlt Issued shat{bocome invalid
<br /> unless th�work authosized,by such garmi#-Is.commencrad�uvtti�ln sE�c monihs af permlt lasu�ncs,or!f vrark author+zed by
<br /> the permfit ts susp�ndod ar.abandoned for a pertod of-'si�c{8}months after t0�e time ttse warkls cammencsd. An eactenslon
<br /> may ba requested,fn writing,from the BuAding.Offialal for a parlad not to exceed nlnety(90)days,e�id w(II demonstrate
<br /> �t�st�able cause far.�the axt�nsion. lf work ceasss:for nlaety�(80}conaecutive days,.#he�job is.aonsfdered aba�doned.
<br /> �'VARtd{hl�TO Q�6'�NE&t: Y�llR.FA6LURE.TO R�GORCd A t�0i'dC�:O�C�Mld�et�CEH1�t�T��9l��'•RESUL'P IN YOUR
<br /> ?�°s�l(V¢a'PI�ICE��?l31NlP'ltOF�EMEP17'31`P,2�OUig 9?EtO��Ri�. IF�YOBB:IdS��D`'fO Kt�'F�IN-FltvaAfiP16:1P1fa��Otd�ULT
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<br /> FLORIUA JUF�AT(F.S:117.03j - ' %, -.-_
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<br /> �vbsatbad attd swom to{ar afilrmed}6eiore me fhls Stihsaihed'Fsu!'sv�om ta{ct a rtnsd)betatEtt t�s Rhi�
<br /> by 'by , .
<br /> Who islzre psrsonelly knovm to me or has/have pmducsd Who ic/are paraonslty knovm to m5 ar haslY�ve p�.�
<br /> ae IdenNBqtlon. ���+c��c-
<br /> � Plotery Pub?Ic °:c�-o F.i�
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