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<br /> NCiTICE:QF DEED�RESTRt T ONS: The „ � �""���''��"'���''��°'`;�'��
<br /> C 1 undersigned::under.stands::that;:this pe�mit�may;be:s.ubj,ec#�to.;..de.ed�;rresf�ictions;;�4:;:,.-
<br /> {�II�Cil.l"�� . �,_* �k.� ..� r a.� ua,ad:-� r,-..-..3�ysu s�:`'i7�,.a,no-;§�'-� �y�.;�r`:'�'1.�+:»:t i;;:e�;�A „}� ,
<br /> r.. ,may`.tie}ii%orerr,esfricfive�th�an�`Gaiinty�regulatrons.�The1.cirideFsigne�`assum�es��r�s,p.onsibiCty,�for..compliance°��nnth:any.,'` �
<br /> applicabte rleed testrictions. - .. ¢;+�f�:;,��r-�� �£
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<br /> UNLIC:ENS.ED:��CON�'RAC�'C?RS'AND� CONTl�AGTOR. R�SP':ONSi�li:i'flES: ff��the��•owiier���ias=��•�iiced�'�a'�c�ntractar.or ;f° <
<br /> contractors-to undertakeJwork, #liey,may�,be,r.,quired:to bes�licensed�in accor.dance vuith.state;and�loc.�l*tegul,a�ion's°:.�If�tli�e��-.=�` � �
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<br /> contracfor is-riot�licensedr as�req,ui�ed by`law, potli:�the otimer�and�contracto�-�may��be�cifed fc5r���crtisdemeanor�viol.ation �
<br /> under state law. If the awner or:�inte,raded;contractor..are�uncertain as.ta what,ficensing:requirementss�i�n'ay�apply�;for�the=�;�MX��'
<br /> intended wor�i,#iiey:are-advised to cor�ta'cf�fhe P�sco Couriiy`�uittl�hg�insp$cfian D`�visionM�'L�cerising.S'ectior�at 727`8447_ ~ � ','`� ;;
<br /> 8009. Fur�hermore, if #he owner has°liired-a-contractar ar con#Tactars, he�is advised to, Mave,.th,e�^cantractor(s}h,.s%gn,,�b,Y��= {,,� �;
<br /> portions af the contractor Block- of this.application,far which-•tlaey_uvift,.be,::r.esp.ansibJe.;.lf:you, as�'th"e�ov+i�ier*stgn as the $r t; �.
<br /> contractor, tliat-may�be an Indication�Ehat�he�is na# properly licensed an'ti�is not entit(edy�to permitting ptJvileges irt Pasco�;,,�{.r� 3 �!
<br /> County. . , ,.. , . -> � - . .s.�: . . ;,� is
<br /> TRANS�4RTATION IMPACTI.UTIL'iT1ES�tMPACT�►1VD RESOURCE RECCIVERY FEES:�The undersigneti.under.stands: fa '��'� f�
<br /> that Transpartation lmpact Fees and Recourse Recovery Fe,e..`sr�may:appiy ta;the.construcfion.,o_f._new,.bui�.dings;.•.clia°m`ge}ofi`=��=>'r si;¢ �i
<br /> use in exlsting buil�ir�ig�,�or�expa�sion of�:exi,:s#i�ig'�buildRr�gs, as spec�ed in Pasco Counfy Ordinance num#aer 89=07.an:d _.�,� ,,f �;
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<br /> 90-07, as amended: The�un+tlersigned also.understands, that such<feies; as�may�b.e>.due;'wi1F`kie;.identified°`�t�thery:t'i�ne�of�`t�i�'';:� ;� �4
<br /> ermittin It'is further understood ttiat Trans ortation !m act-Fees��antl Resource=-Recove Fees�must be aEd p�ior to � ��: �'�
<br /> P 9• ` P P ry ,, .; � .,
<br /> receivin a "certificate of accu anc � ar final.. ower release. � Ifthe., r.a,'ect does not�irauolve a ceitificate of:occ�panTcy.>oi�<��=-�i' ��� "
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<br /> finai�power-reieaser.,the.fees�must be..paid prioc to permit issuance.i;EurtheKmore,-�f Pa�co:County Wate[/Sewer�Impact . : ° ;;
<br /> fees are due,.ttiey,must;be pai�prior ta perm�tissuance-in.�accordance with=applicabie..pasco�County ardinances. � � 4�
<br /> CONSTRUCTION=LIEPl�L;AW{Chapter 71�5; Flc►cida Statutes,as amend�d): If vaivation of work is$2;50�0:O,O�or-.mor;e,�:l:;,��- 4
<br /> certify'that I, the�applicant,.have been provided with-a copy:..of_:_the�."Ffoi�ic}a' Cansti�ract'rbn�£ien Lau�Homeawner's�
<br /> Protection Guide" prepared�by'the Florida Department of Agriculture and Gonsumer�Affai�s. !f the applicant is;som�one.;�..- . '`
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<br /> other than the°owner",;I eertify that l=have obtained"a copy of the above'desc`ribed��ocur�ent=�and,p�mise-:in goo.d`faith�;to ;,. -
<br /> de(iver.it.to`ttie"own.er"�prior::to':commen�ement: ' � =
<br /> CONTRACTCIR'S%�{AINER'� AFFIDAViT::_;I�cerkify�tiaat='a(I'tfie inforr�ation in this application is accurate and fhat all`work `
<br /> wif! be done in car�tpliane�with ail applicable'iaws regulating construction, zoning�:and_land-development. Application is
<br /> hereby made ta obtain;a�,permit:#o�°.do,:;work-and_ instaflation as`=indicated. i�certify fha# na wark or.instailafi'on�has ;;
<br /> commenced prior tci issuance of a perr�i9t and��#hat alf work wii! be perFormed to.:rr3eet standards�of ali laws regulating ' '
<br /> construction, County and City codes, zoning regula#ions, and land development regulations in��the jurlscliation: °'�I:�also z'� �i
<br /> certify that I understand that the regulations of.other government agencies may apply to the intended work, and that it is �:E `?
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<br /> my responsibifity to identify what actions I must take to-be in compliance.,Such.agencies include:but are not<limited.to:. ` _ M }
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<br /> - ,Department af Enviranm�rita{;`�Protection=Cypress Baytieads; Wetland Areas and Environmentally Sensitive =;�� ��i
<br /> Lands,WaterMfastewater Treatment. ` '" �
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<br /> - Southwest Fbrida Water Manag�mer�t District We!!s, Cypress .Ba�rheads, Wetiand Areas, Altering � ;:; {j
<br /> Watercaurses. � r : ��� �.]
<br /> - Army Corps of Engineers-Seawalls, Docks; Navigable 1lVaterways. ' r`:� (-,
<br /> - Department.of Healthr;.& Rehabilita#ive Services/Enviranmental,�:Health•'.Unit=Wells, Wastewater Treatment;� ; ;`
<br /> Sepfi�=Tariks. �= s + � {;
<br /> - US Environmentai Pr.otec#ion Agency-,4sbestas abatement.
<br /> - Federa!Aviation;Autk`tor.ity-Runways. � �
<br /> I understand that:the�ollowing'restric#tons apply fo the use af f:!!:
<br /> - Use of fill is not a0owed in Flood Zone"V" unless expces�ly permitted. �
<br /> - �f #he fill material �is to be used in. Flood Zane "A", it is understood that a drainage plan addressing al �
<br /> "compensating volume"will be submitted at time of perrnitting which is prepared by a professional engineer; � �
<br /> licensed 6ythe'Sta#e of Fiar�da, � �
<br /> - If ttte f!1�matsria! is #o be used �n Flood Zone "A" in cannection with a pe�rt►itted building using stem wall,
<br /> construction, I certify.that fill will be used only to fil!the area within#he stem wal1. , ��;
<br /> - If fill� material is ta:be used in any area, I ce�tify that use of such�fil! will nat advsrsely a�'ect adjacent; .. � '
<br /> propert�es. tf use of ft,I( is found ta adversely aff.ect-adjacent properties, the owner may be cited for violatingc °., �.�
<br /> the eonc!%tions."o€<the�buiiiiing,permit.issued und"errthe�attached:.per.mit:ap.plication, for lots tess than one (1)� `�% �`
<br /> acre wt�icfi are elevated by fil1, an engineered drainage plan is requi�ed. � ;:� ��1
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<br /> !f I am the AGENT fARTHE flWNER;-E:•.promise in,good faith to inform the owner of-the�per�rtifting conditions set forth in; ,. �j
<br /> this a ff idaVit prior to�corrimencing const�uction. I understand that a:separtate perrriit may be required for electrical wor.k,r ° �
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<br /> piumbing, signs, wells,. pools,�airr„co,rtditioning, gas,;.:or otlier"installations not specifically included in the application: A.;. �: i._{ t�
<br /> permit issued shail`be',construed:to�ie a license;to.proceed with tiie wark:�and nofas.authoeity-ta violate, ca�►cel, alter, or; �`;
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<br /> sei aside any pravisions�of°the"teahn�cal codes, no�shatl issuance of a permit prevent#he Building Officiat from theceafter; �%�
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<br /> requiring a correction��af.;e�rors�inrplaris;�`conste,uctlon or-viofafions�af any�"coiies: �Every perrrrit isscred sha11'become invatid� i,;;,, ��
<br /> unless the work authorized by such permit is commenced within,si�c,mantfis of permit issuance,;or;�f work authorized by i; ,' � j }.
<br /> the permit is�suspended:.or.abandoned for:a�p;eriod�,of six(6).months after the time#he work i�comr�enced.� An extens�on s � ,.� �'?
<br /> may be reques#ed, in writing;�'from�.fiie Building�Official for a periad.no#to excee�tl ninety (90}days and will demonstra#e � `�i ��
<br /> justifiable cause for the extension. -If work-ceases for ninety(90}consecutive days, the.job is considered abandoned. ` ��� i�s
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<br /> WARNING TO��OWNER;� YOU;R:.FAILURE,��t?;;RECORD3A�MQTtCE��Q� CCIMMENCEMENT MAY�RESUI:T IN YOUR-! ���7 }���
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<br /> PAYING,;TWICE'FORj:IMI?ItOVEMENTS;�'�O YOUR-�RROPERTY:; 1�YOU,IN�`END'TO,t?BT'�11N��FINANCING;C�t}NSUl.T ! ;�;; ;;y
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<br /> —WtTH�Y�fUR='LEdd�l�R O �iQM-�4TT�1�(dkV-� �'�lR��RECOR�II�C-1��1J�2"<(�ATICE`O�:=CQMMEN�ENlEI�T._..--------___.���_:_.__ '=;� �_�-
<br /> FLCJRtDA JURAT�(F.S. , , . , • ,. . �, _ . .
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<br /> OWNER OFt AGE CONTRAC70R �
<br /> St�bs���l. d m ta(o aftirmed} 'e re me this Subscribed and swom to(or aflirmed)before me this �
<br /> bY .
<br /> Wha is/are onal y kno to me or has/have produced � �Who is/are personally known to me ar haslhave produced +
<br /> as identHicatlbn. as IdenUflcatlon. � '
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<br /> GL%�- " ,� Notary Public Notary Public
<br /> Cam sEan Commission No. � �
<br /> „���, =_—..�,.
<br /> _,��a:"•"••.ru�� JACQl�E�tNE BOGES
<br /> Name of Notary - �� ember 12,2p1g �ame of i�otary typed,printed ar stamped
<br /> ;�P:;*O`', afl�waaT �
<br /> ,�r. r tuu7royFamtnsuranoeBDa395•7018
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