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<br /> ��`i������lEf���(���'B�IS�'�����: �'����d�����ei�d aar�d�r.����ds�;ti��g.t4�l�.���cmtt:m��.��,�ub�ect fo°d�edp rest�ictlon�° .
<br /> whtch m�y b��more���st�ictid�-4h�n C��anty.�gut�t(oe�s. �'�'�a�uhd�r��gn�d�s�ur�o�����pr�n�i�Si�iit���t���orrip�€�n�e v�h��i�t
<br /> app##c�bf�d�ed resbrictloe��. . . . '
<br /> �9(��Q�E���€��3 ��h��°�t�'���� ��8� ��i��'��°�� �3��6����H��I����: � t�e �u�r��� tta���htre� � c�n�ctor e��
<br /> ccrnQ��cfe�Ps 4a und��@ak��ork, th�y rn�y be=e�quir�ad�to:bg;8ic����� I� ��coPd�nc�.�uiQh s�����.�nd•loa�l regul�teon�. i�d��
<br /> ca�e�tr��4a�� t� n�t lic��tsed �s �ec�u#r�d-�ay 1�, ��Eh the co�vrt�� �t�� exiatt��cat�r srt�y�b�-�f@�d-fo� a mtsd�rn���o��iol�tton
<br /> �sa�d�P �Q�4� I��nr. 1��h� o�vn�r av� lnf�r�d�e9-c�ntracR�ee are�e�nc�t@�0n �� to v�h�d i6�ns6ng.r�qulr�en�nts �a�y appty-for th�
<br /> fntend�e9 rr�o�c, 3�ey�rg ae9vl��d to�oatf�cQ�h�r.Pascm�out�ty�u9lding 9aesp�s�t0oee Dlvislot4--(Lic�nsing a�ct3on at 7�T-��7-
<br /> �300�. �e��th�rmoee, if 4�� or�a�r h�� fi�t��d � �o�i@r�c�a+€ �r c�ri�ctoPs. R�� �� a+��rlsed �� hav� th� c����ct�r(s} sigra
<br /> portioer� of�h���cor�Q�,ctor �lock° og�h1�.�ppBiostt�rro �or wrhich 6h�y v�rll� b�.r��pon�i�te. if yoaa�.�s.Fhe o�rner"sige► a� t0ir�
<br /> co�#c�����, ��aa�t m�y b� �a� i�cDic�sQl��4h�t h��6� ��Q.����eriy�i���t��d 2�nd �� �at�e�tltE�d B� p�rr�6ttlt�� prlvll��es �� P�is��
<br /> County.
<br /> �'�(��E��G��'�'PI��18�����'/�J'�8t�8�'�(��-86����'�°�f������Ml��������l�f��'����:��'�e under�i�n�d und�rs�ands
<br /> fh��1'r�n�po�tt9on qrn�acQ F������d.R�couc��R���tr�cy.F��s�t�y:�pply�fca:@��c�ro���act��n s�f n�w bu�lding�,°�hang��f
<br /> us� in �nisti�rg bufldings, c�P:�xp�n�Iorn��f-���i�tin,g.`�6ulldings, as �p�ci�i�d.in P��eo Cour�ty �rdi�ance� �urnber 89-07 �nd
<br /> 90-�7, �� �nn�nded..:The a�e����i���d a�t��ean��p�Qa�ds� �hat����$��s.-��:���_be•dt�em;�irf116� #dea�6i�t�d �t�he�#t�ne o€
<br /> permittlra�. I@ Is fu�th�r und�rstog� �h�B T�¢�spoeQ�tlon Im�act����� �r�d'����ur�e Re�o��ey �'��s rnus� b� p�ld pPior to
<br /> eeee�vicag�°c��t�ic�g�og a�c�tap�tt�y" c�a��i�tai-pm�t�r=.��l�ase. :I�Q��prc�j�c�a�o�s nat invt�4v�.��eeti�c�Qe��occup�ncy.�or
<br /> �nai p�vv��r�6e�s�, 4he fe�s mat�&�� padd prtor#ca perm6� isstaaa�ce. ���h�r��r�;�if.�����_Ccatan�y'ltVa��rl��n+e� �rnpact
<br /> fi�es ar�du�, Bh�y.mu�Q be�ald.pr9oe�o permit-Issu�nce=ln a�c�r�arrce avlth��pplic�bl�P��co��ounty�rdi�ances. •
<br /> �����'�t��'���t�l����[���������s'�9�,g9�r����#������,����c�����; i�vaEuatEo��f vuvor�C Is$�,500.�i}or enore, }
<br /> certif� 4h�t �, 2h�. ��pifca�et, h�de-b�en pr�vtded with � copy of��h� ��Imrida-���nstrucNon� Ll�r�.Labw-Homeo�rner's
<br /> �'rot�c4i�a� �t�Eden pr�p�red b�4ti� �1b�lda�1ep�e�m�e�4��f Aget�t�IQt�r� �n� �a�n�um+arAff�l�. !f th� �pplt�t�t 1s �orr�e��e
<br /> ather t�an th��owner�, i�erti�y�hat 1-h�ve,obtain�id��c�p�:��:�h�:��av�..���.eeiti�d�dbcument�a�nd.pra�m[s��in.good$�ith��
<br /> d�l�v�r Ik go Qh�.°a�ra��a�'�pri�e#o•cvmme�ncem�nt. ' ' .
<br /> ���'H""'�l�it�'��I�'�����t�°�������1iB�': 1.cei��y.�hs�#�Il-th�.ls��rm�fd�a�.���his�pp9t�f�o�e 6s��curat��e�d that�}��c��k
<br /> will�be done 6n �omplianc� with ail applicable laws regul�king c�n��nactio�� �onin� and�I�nd�d�v�topm�r�q. Appll:�tion is
<br /> E er�by c�ad� to trob��ln .a permi� to do �rar�;and ii��t�ll��lon �� dndt�$t�d�- =! c�rt#�r 4ha�t r�ca v�ro�k ar Instaitat�on h�s
<br /> � commenc�d prior to is�u�nce of a permit and th�t.all wortc �r611 b� p��FoPrn�d�Qa� Pn��� s�anda�rd� of aU i�ws e�gula�inc�-
<br /> constructlo�, �oun�j and City cod�s, zoning regul�tlons, �e�+� land d�vel�pm�r�4 r.egul�tt�ns 4n th� Jurtsdiction. !�al's�
<br /> ce�ify that 1 und�rsf�nd thaf fh�r�gul�fio�� of�qher gad��m����g���t�� m�y���Pi��tc►#h� ir�Q�nded r�ortc, ae��tha� i�is
<br /> my responsibility fo IdeMify�what,�cQlotls I�tti�t�t�k�:4o be�ln�a�rvqpl9�r�c.�: �a��h ag�nc(��Onclude but�r�.na�I�mi��d fo:
<br /> - �ep�rtt�t��t of E�vira�e����f�i Preit���iaa�s-�rpe��.�������d�;��§l��I�nd �i��s �e�d En�rlrongn�eata�4y ���sitive
<br /> �.�nds,V11at�rAlV�st�wr�f�r Tre�tm�e�t.
<br /> - '«�Ol1g�1FA!@�$ ��0�l�� ��@8P �c'�Pt��@PPi�T1� .��StP��.�����$r �'jt�P+�S�.,.����'9�tr`���; ��t�c'�lt� �9'IB�S, ����f�Pt�
<br /> t�'ag�r��urs�s.
<br /> I - �rs�ay Carps of Engine�rs-�0a�alls, Docks� N�diga�le Wa�t�rvu��rs.
<br /> - Caep�r�m�r�$ �� Heal�h�=� �ei�abllltative �ervi��sl��a�i�onm�e���l �$���t� ��t�Q��ll.s, 1�ta�tevd��s€ �'��tr���nt, .
<br /> ��p61c`9'a►it�s. .
<br /> - �!S E�vi�nm�n��C�'r���cQlon Agency�As�esto�aba�e�eni.
<br /> - ��d�r�l8�di�3lon A►uthority-Rurnw�ys.
<br /> 1 und�rs�and tFiat Qh�followring.restrldtions apply to ghe use of flll:
<br /> - Use ofi#i!1 is not allawed in Fteod Zone"V'un�ess e�e�sly p�rmitfsd. ;
<br /> - if the fl1I material is ta be us�cl �n �cad �o�p 'A', (t ls understood that a drasnage plan addr�ssing a
<br /> "oompe€�sati�tg va�urt'teg wii� �s sub�n��.� �t�r� of�e�ztttlr�g �ich 3s prep�red by a ptt��siona! englneer
<br /> licensed by ttxe 5tat���1t�r}d�: i
<br /> - lf the fill rr�a#���i�? i� t� �s us� � �� ��� `r�T i�c��e�tion �nt;t�-� �ermitf� �.�ildFng usfig stem �ral! l
<br /> � cflnstructarz, i c���:�����€��.=�e��c c�:�`�;.'•,r�������ea��ttn-�.��t�rr�;�. - I
<br /> - if fi(I materi� � r� i� �sea �r� �:�r ��= t �=�x �:T�:-� tra o,r scrc.�a � �,�� rroz a�versefy afrect adJacent ��
<br /> �}1'C�38��'°�, �i li:� fl�s� eg 'sF''�:sT:°'� � ��`i?�`..E�..:.s"'��.'� �;�i�t'L^.��3�.�.`'^., �.r�Y$ �i�r'F116I' �F'!3}'�� L��� �01'.Y���c��Ill� i
<br /> ttte cartdE#ions �r tt��. �b,��.�� �+:�-�i 's;,�� t�.�yr �� =����d ���� ��?�`.�!i�or�, for }ots (ess than ane (9)
<br /> acr���h:� �e��at��y;����e�:������.r��g��x�r� t�a�uir�f,
<br /> {f 1 am fhe�fiENN�"�OP 7"#��a'e'�4I�'�,°, k_��-�-�s�i���..�.�t.�r��aa the a�rr����tl�t�}�e�mit�ing canditi�ns seE forth ir�
<br /> khis affidavit��prior tcs c�ain���rtg c��s�.�;��a. I u�=_��:�d tf�at a-se�arate pat�t7it rnay � requ3red for elecMca! wor3�,
<br /> plumbir�g, s�gn�, wei3s, �s, a'srr car�+i.-i.�r�'sr�v. �: � ct�-� in._.s�aE�ona not s���ca?Iy Induded-in fhe applicaEion. -A
<br /> permit(ssued shall b� arr�strued �o�e a ticense €o ���t� #�s r�rar�and noE as a.ut�ity� to.vi,olate, cancel, alter, or .
<br /> set aslde sny pravislons crF th�t�hnk:�l t�d�,rut�shai k�u�.rres�;a �srml#pre�en�� 8ulldtrig (7fftcIa!fram thereai�
<br /> re4uiring a correction afi errors ln ptans, cansfructIon oft�'�t3�c�as ef any codes.� €��ery g�rmif lssued s�ta4i bev�rr�e invaiid
<br /> un(es� ths�ark authorized by such germit-ls.ao�nmene����tin� rnonth� of p�rmi# ls5.uanc�, or if wark authvrized by
<br /> the permit is suspended�ar abandanet!for a pe�od �f sbc{�}�ron��s aft�r the t�rne the wor���car�menc�d. An�x#ansion
<br /> may b� Pequested, in writing, from #he �uliding.O�icfal fo�a �reriad nat fo �xcesci�riu�e�y�(90) days a�d will demanstrate
<br /> �ustlfl�bl�c�us�for�th�ex��nslon: Ef wor�ct�ase�.for nlne�y-(90)c�nsecutive days,_�e Job�is con�Edeted abandoned.
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<br /> �UtIPdEI�093 k1f33�R1Y �:Of�l�'q$6�GT0
<br /> Subscr�bed�nd swom tv{ar afflrmed}befor�me this � �u6�c be and's m�ta{ot afi�letned}•befats me tMs .
<br /> �;�,�-�--by �by� -
<br /> Who tslare persan I y , to.me or haslP�add producad Nbho.ls/a e per8onaily kn��t�me or has/have prodi� =
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<br /> �'�1����/1� �lotary Pt�bRc . 4��.-�'���c �
<br /> Commisslon Pla:' �? D �J� C�.�mrrf��';�. �Ct~ d �L�j
<br /> � a ��� i�,� v �rr �'1�.��_ ����1� .
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<br /> ����- Y PU�4, pEBRA EI.AINE RUFFEtt � -
<br /> :?4t��"'�'�, C1EBR,4 EIAIN .
<br /> .�;: E RUFFELL •:P"�••9cE;,
<br /> _ - :,:Cammissipn#GG 045343 � ��'� Commission#GG 045343
<br /> ;;�eA;=Fxpires No mb 024 � �^'• � ires November 7.2420
<br /> ve er 7,2 ;.�o:Exp
<br /> •�.,o�f`�••• ��dedThNTroyFainlnsurance800-385�i019 �':;'odf;°P; BandedmruTroyFainfnsurance800-38�-7018 .
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