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at $o die,. CitjlAofY /e h` 1, # ; Apl 1d0-t1>�f pax b tlo'
<br /> AbIldiii
<br /> NQr1E:�5 'b�ED:F2Etrt(CTfONS:1 he;ifn�ersl ne�'uife ta'ds ttfat tfi rrilit:ni�' e` b t '1 i'eSMititie n e s�i. '7tt3i; t�ic8ons�;wFii �ma �b��non'§. 'i
<br /> than°,County ulotions The undersi netf;assu es°ras nsib rrcc..'• Ilarice;with agy a Iicatile:ileetl<regtri y
<br /> 9
<br /> rag g !11 _ .,y Il inp Pp coons.
<br /> UNLICEN$ tgCON RACTORS`AND'.CONTRACTORaR SRO I ILiTIES If th@ owner;•ieslrirgd boric etor t, nfractort toighn ortatie:w7
<br /> maybe,required to be-:licensed In acconiance with,state an8'local regulatlor(s:"If.ttie.contrdetor is ndt Ili efise aS reg411 ed liy is yAlal-4f=ie bwner:and
<br /> conita6tor,maybe.citetl.for.a;misdemeanor'vibe'a�tian`iJ�iHer tt3 %ilfdleo, e�;ort tendett'co tfa torafe.0 CeCtalit.a§to; atltcenSing�etqurt'111ettits �e�;r,
<br /> may,apply`foofi"ttie mtelida<7;vVdHi�'they are?adviseil::to'.conted tlie.Pasco CAyl3iifl�inE`slits'pacYn: i`v15iu� te}islitig; € 7 `�00 :'`''"
<br /> FurWiirmore,;if-the:owner has hired.a conira oror ti :'a rs` s adiils-i-Ao:haVe;h6(;oritraao S `st-li;: ortldits:df+tlla�' 'nfra `r:BCoCk";o'flits
<br /> applib` 8brifc�wftbh"tfie :uWll`b'e:responsi6le:Ifyouu,as:tfiaowner'sl n.as:tht3;t �itf�actor:tft8tinlay i an-intllt ititlri:that: ;is'iiai i fii ' fFittf 4,
<br /> nofeit'title"1i'te`earl`iiittirig�I�Hsrileges?ih'Pa'scoCauntys-'; ,.. ,. :y:�•..'.-:�.;;•:�..=-.::.::.::...:.-,�- - a:.;.:,,�;4...,.:,;�._.
<br /> TRJW9Pt�RTAT-46-4MPAGTi&irrI 5 .-IMPACT AND`:faESOURCE ICE-OVERY(FEES'.'Tt_a untle�igrl!d:u stands',:
<br /> that tkanspoffifldml-t_act Eees ana';Recoiiise:Re y Fes' `I. Lt7l: :: irlittjjCEicf ¢ air► an l:°`` :r.: os i� at
<br /> expahtlon:of exisdngSuildings as specified'in Pasco;County:Oniilrance:nGrhber 89-0Z hnd'90-07-as-:arti rtdGG .tTit iurrc a sign al_stS understands;:that'
<br /> sucliifees;•as•ma be=flue vtnll,be idehtified;at;the:time.nf, ttni r� It l$', r 0rtd$istood ttiat'Trans otta 'oit.lrrl apt Fees ai(d kesQurceR
<br /> Fees must' a aeid;piior t receiving:a°certificate:of ocaipaney?or.�irial owetAlease'.`If dii, _ doffs;_•ist�nvdlve„ +oeFHil a' "b(~�ccyp
<br /> poW..er release;the;fees must tie paid,pribr.tb perrii1t issuance:Furtherrnore;tif;l?ascq�Coutily:Vllater'%Sewer 1mpAet.fees'an3:due; Fiey:riiust 6e p8ld,piior.
<br /> topermItIssuan.be,n-accord6nde•with;ap ifeable;P'S'w}l° uo itbrdinances, ':`'"''^": �' a..,. _ - '=9;s
<br /> :,,r,:;
<br /> CbNSTRUCTION-LIEN (CAapte�` 1: ; cod : as-arrleinto'!)::1f:vatuatiorr ofwoili.is$2 500:Oti or:tmo e�lVolrtify�ttiatil_the apPlicanit;''
<br /> have:been'proihdeii:Svltli�a"copyoftlie"F►orlda.t;cnstiictidnLlettt;2W"HreOwr�ierRreleCtitot1if8 afkdby FioJidaepartnijl Hof ;:,.:•.:, ,.
<br /> Agriculture aril Cbnsumer Affairs.,if the.applicariis�ssomeone otherth''al'i;tha..owner"� :cCtlfy'tlt.,t i`haire :° et)a cro yof; above desef ' -:
<br /> docu eht and:promise;in gooa.falu,;'to.aenv�r.:n;toah 'ovimer",;prior t rmmoncmenC :.w:.:.
<br /> CONTRACTORS/OWIVER.S;AFFIDAVIT Icertifythat'a`113ltfeirlidrmtlgrZi thisaptiliationis:',ccilr+ati�an'dfiw;etcIlwork:vV�ibe:done'In;oomp�(at, aNith.,:,; ;:
<br /> ilcaf ieleiivs;;reguietiitig constiction,zoning;e11F dhd4#0 dpmet eeby: a eai'
<br /> alga peth mgcnepror wcat o ceoirmtaitlndl o
<br /> laws'* latng.construction;:Cbuntyarid:City,:codes;?zoning.reulations; tl'b: roo ta(ii't?lla�,p�pmer)fitn rMcte dY°,tuao;'za tdse)asr�i tatt$.ti fa asi l+.f .. :.
<br /> a itliand deVelopm�p,Tegula cnslri bil��ur('di '(fP? I also:cet11f3►that'I
<br /> undersiand:that the Molationsof other,gove.[nent�gendes may apply to the intended work antl thiit itsls my resporislblli[j.461den f�r,vrttatadions:l ?::. :.y;
<br /> must take to.be.in•compliance..Such agendas;ihdUde b'ilt.ara riot limit cos
<br /> De artrnent`of Environi'nent�l#',*,d O-c'tpn:Cyprets Bayheads V�/Otland.,A eas:and EnViFonFrretital,y Sens••itive,
<br /> wafer T p`�atrrteri{ _ �/
<br /> -Lands Water/Waste. �.. ';, �y�. :
<br /> v _ _.q c..;f� .r•T.:'�,y �."K?- 7�', �;;c: '�'1'"�'qi:: n.�n._ t(n1'•:,'�:4fY7[.+.
<br /> Southwest. Florida' Water iUlanagement°(%C?iStriCt�lNel�s,f-"Cypr .as> 8ayieatt : ' irtl2las;:• l�telt '
<br /> Watercourses.
<br /> - , Army�Corps of EngineersrySeawalis;�D•ocks;Navigable:Waterways:
<br /> Deparfine-t�of lealt'Fr&�r eiiablll><ativ Sarvict�sJ8�ivtr iifltehtal l esltli Unit`�iNells:'; I,Vas'tewater:� reatrxt: nt .
<br /> Septic Tanks.
<br /> US EFtvironmental Protection Agency Asbestos'abatement. ,
<br /> Federal;Aviation'Authorky.Runways. s
<br /> understand that the following resbictions:apply',;to-the:use,of -
<br /> - Use.of:firis not allowed iin,f• ood done"V'`unless":expressly permitted: .
<br /> If. tWfill•mateHal is to,be:Used:in<:flood:yZgrle °A it.•is un rSttS 'tFi h`a'=drairiege: plaC�:addressing a:
<br /> compensating volume vuilt.be'sut�njiatlat=<trrie'.bf oePP>t`ring uuhicfiks•;paredy "<professionalEhiei :
<br /> licensed;by:'the State of Floridi:.
<br /> " ; ::.e i ng;lasing stem viialf.: '
<br /> Ifthe fill.material. is''to"be .used'in Flood.Zone: A in connection.:with: petmitted'.:buidig
<br /> i�l. tc>till�tl 6-a.00m, 111hit .:.,
<br /> �construbtioh;At=`certify:�tlat�ll.:w;lF�b.��isecl�. y� ,.,W.,,1�J?a.. �r,,_. ,_;�..,7.. ..::.:
<br /> ... ..•. 'r+wr....._ :.y..(..,.u..y 1. .' '
<br /> ,,, . , fill:'will':nofwadvet�ety�ga�fect:�:ad aierit'°'
<br /> •- If:fill material`is•''to'be-use'd"'i�l":atiy.'�ara� l:ceitify;that:°us :suCF��:�� .�,...,
<br /> adders l <2iff ctfi d'acent;pcope)ties;.;the"6wn&mbY,,be clterlor:viold i�tg�i;,��.
<br /> _propert es...af:;us. f. i;• ._.Q: Q.. versQ..Y 1. ,
<br /> w e' a -it;a licetion' for'lotsaess'tleriotaeF,. ` �
<br /> •:.
<br /> .,.
<br /> the conditions'of'the1.l;'ull�ditlgperlx[i isstied'uilriet by 2tta. h,•,41 p4.1 .^,...,pPi.,,
<br /> acre:which-are-elevatedan:engihieered
<br /> If I am,therAGEN7 FOR'THlt OWNER;.I:pH m1pe�iri:gooiffaHh'to•infonn the yweerl::0. he pernittting coridltiohs set forth1n thts affidavit Priot:to, :r -r,r:t,.
<br /> n�ctiiis6if6$6e1 Wd6'rstA.d'th�it'a separate° errtiitri eytb�e-requlred or.elec{rical nroY 1 gr. igi , rifeflsjp�obi ;ai ccnf grling;;gss;o�
<br /> commeiicl g..
<br /> not ecificall'tncluded.tn>the appNoation:`iAsperrriit:issued IlGe conUuetL'to;flee.itceiise`to'ptopeedtv�iltti';tho;=v�ibtk'e' lriot'a's;
<br /> othe`=installatipOs .,p ._,, ..,Y .'. .. ..: .
<br /> - ;> asidwan' roilsions;. `e°.tebhnY } by �itotsh'all>issuance of a;perinitprevent-111o;.Buif llr g;OAi
<br /> authoFi7to�iblate,.ct;el+. lter,,or sit. J y p �, 0,�,�.,
<br /> thereafter.lequlting a bo reotidD`:of elrp s.'iri:p>�ans�;co�istiticttoi'+tar vibfatiorie bfE ri°j�,' es:'fVevy i`ri�it�is 'ed,5Ff81l be siftie levali ;u
<br /> d "" ~ r iV '.Out! dezf�orr�baritiorie<f:fiota
<br /> authorized 6y such:permit`.is oomrriencedjWithin siz months ofpermit issuer Ce,.or if 'a"17 ioYize lli}i`. P
<br /> ,
<br /> eriotl,df siifi 6 rnoiithsafter..the.time:thewom!.A`WmMenc*d-�An:exteOslo m y,be:rL Uested;.in writlrig�iro `tfie 8utiding; cigl, tap' rlotl i o?,,
<br /> exceet)ninetj%.(90)"d s--aitiif villl�demahstrate JUstiBalil6'Cause t`the:ektension.:ifwork- sesafbr�nlnaty;9g);c6ns�et vet Y r )ob7s coriside
<br /> abar3doned.
<br /> F;Ct�M ENC.'MEN � M.'',.,
<br /> ViINR. YID',UIZiF%A��fUlt .' ly"RECORD (7`ICE'b Illys.
<br /> WARNING:TO=O, .,'r,•, k- Q -� ;
<br /> p. ,�'IF"'OU
<br /> PA1rIIVG`TWICE:FOCt IMPROVE , OUR;iEI . . `
<br /> FLORIDA JURAT.(F:S6.
<br /> :"117.03)
<br /> OWNER OR AGENT ;:.:`.......... COIhCC70
<br /> Sub::scHbed'...d swom•to(or'affirtned)before me this SubicAbdd antl`swornitti-(or affirtned);tiefore
<br /> rhasmave✓roduoed- Who.ls/a`re. -' dliy twiliie areid p �, ,-,. _.,>
<br /> Whd'is`laiep"e'rsor'lfillyRifowri'tomen • --:; p
<br /> avidentifioatibn: L as identification.
<br /> ;Notary '. : . . 'No�Fy Pu Ilc.•
<br /> Public
<br /> ' .ComnissioO'15q
<br /> Commission'No. 7-7
<br /> - =,,i•, b • ..:_.y. F� : f:.',,
<br /> ,
<br /> Name of Notary typed;printed orstamped - '''Dame of'Notary,typ ;sprinted onstampeds:- _ _ __- _ --
<br /> a.
<br /> ;; oi}�•: CARLOSMALDONADO
<br /> �' Commission#GG 346275
<br /> r, b�'Expires June f8,2023
<br /> `'•„or.R` Bonded TMu Troy Faln Insurance 800.3W70%
<br />
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