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PERMIT APPLICATION <br /> UTILITIES LOCATE CONFIRMATION NUMBER: <br /> PROVIDE SKETCH IN THIS AREA,IF ADDITIONAL SPACE IS REQUIRED,ATTACH TO THIS <br /> APPLICATION. <br /> AFFIDAVIT: Application Is hereby made to obtain a permit to do work and installations as indicated. I certify that all foregoing <br /> Information is accurate and that all work will comply with all applicable codes. I understand these codes shah take precedence over all <br /> approved construction documents,and issuance of this permit is verification that I will notify the property owner or Florlde Uen law <br /> req.,F.S.713. <br /> The issuance of this permit does not ensure compliance with deed restrictlons and I understand#at additional deed <br /> restrictions may apply to this property. <br /> All work shall comply with the Cirnen Florida Building Code,Public Works Design Manual and FDOT Design <br /> Standards(if applicable). (Public Works Design Manual online link:www.drephyrhglsfl.us/pubDc—woft.asp) <br /> APPLICATION IS VOID UNLESS SIGNED WITH PROPER IDENTIFICATION AND WITNESSED BY A PERMIT <br /> TECHNICL4N OR NOTARY PUBLIC. <br /> NOTE: The City of Zephyrlrigs Is not responsible for maintenance or repairs of drive n ys. Driveways stall not after/ <br /> Interfere with existing M arnrwater treatment and/or conveyanoe. <br /> PROPERTY OWNp By signing this application: I certify that I have read and understand the owrrer/builder disclosure <br /> statement. KU R (please inniap ? <br /> Applicant Print Name Applicant Signature v Clete <br /> PermItTechnidan Signature (or)Notary Signature Data <br /> Applicant is( )personally known to me or produced as Identification. <br /> (type of identification) <br /> Page 2 of 3 <br />