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<br /> NOTICEOPDEED RESTRICTIONS:' The undersigned understands.that this permit.maybe subject to"deed"restrictions"
<br /> which iitaybe more restrictive than:': oufi#�r regulations:'The°undersigned=assumes responsibiiity`for compliance-with any
<br /> a lic I dQ s rrcf"•ns:
<br /> UNUCCNSED C:t3NTifttd#S AND,C'ONiTf 1 `CQR't7�t SPONS BitrR1ES ]fi the.owner iias trired a con#racforhor
<br /> contra. t"rs-#o uncle ke work;:#he' 'a. berraquiredto tie;licensed?:in:accoritance:with:s#ate:and.locai,regultions .f.#he:
<br /> c.9_.. _,.._....... . _ .;;.,., y�
<br /> w�..
<br /> contractors nofi Incensed s:_required:by:law; both'.' o 66il and`cantractor~may-tie cited=for a misdemeanor violation
<br /> u 'rter:s a e law:::=-lf:the owner or ii}#endedFcoi�tFacto are uncrtain:as.,#o what,ticensiog;:rectuirements:maYppiya ',#tee„
<br /> intended work;_:they are ad visedrto'contact tt e:Pasco GouritjrBi ilding°Inspeictton`Dlvision=Licensing:Section at 727=84�-
<br /> .. .yF.4 .:.
<br /> 8066 Furthermore rf•the_ lier_t aWhkdd4.-Wontractori or.contractors;..;he;is.advised to.,have ttto.�contcactor�{s,)•�sign>G,..
<br /> porfions`of''the<"contractor 6to!~k".',of.`:.this::eoplicatiQX�fQr whicit-thQy will.-tfa responsible. if you; as tiie.owner sign as the
<br /> coltractar;that.may:be.an',indlcationthat he,'is:not properlylicensed:and:is.not entitled:to permitting privileges Ain.Pasco.
<br /> _ .. -<.,; ; :_. ( .. :..w� .w, ;=•.. _. -. . ;,n•."r ands
<br /> TRAN3PORTATIO.N IMP�ICT/Ui'ILITIES.IA PACT��rp1ND;RESQURCE.RECrDVERY:FEES: The underdigO d u de.Ystw�,
<br /> that= farisportataon inn c#=flees rtd Recourse l ecover ees may'apPl to=the,constr+uction:of new.buildirigs,` a ge off
<br /> use:in;;existingaiuildings ;iir expansion•:of'existing'tiui(ding ;.asspecIS irr'Pasco`County'Ordinandd-hdmber 89=07•and
<br /> 90'x47 as amendstl:sa:Tte:undeXs fined�als Tn:'' Irs iedathetims:ttafiucrrtees etan nQu
<br /> permitting:,;'It::jsurfleruicterstood#tatf'ransportatiorttmpact•fees;and Resource"RecoveryFees must'be:paid prior.to
<br /> receiving aceirfioate o;occupancy°�Lorfnal:po5i►erreleas . Ifl#h�rjojec :d(ie. iotrinvalve a,;certificate ofsoccupa�iacy.or.:
<br /> Water/Sewer,ore ? sc1i � wrr tm ia County
<br /> fads,are;°.due;tlae`.riiusttie:paid irior#a:perniitissuanii.in., orda.e.0WIth�:licabieaPascoCauntyordinancesti : ..
<br /> t1: ,, 0 ., «^ Ci"ia`'t r7 3'+ ode' }tatotes' a$` r>nen'd'dF:: •If valua ,h of iGiiric is; �'' OQ:OQ.ar
<br /> CQNSTiwE .O'I', ILt'1~A t ?. -F r r
<br /> ce: : #1ia 1 'tie'a `'iirrantaue�beect "rouided;rwith°a.'copY:ot:#Ie "Florida::Cottsfn rctioi "mien::.GaurHomeowiier's
<br /> Pr n yGu dej4prpparect:;byythe;.Ftcrida:DepaAment.of,Agriculture:and:Cbnsumer Affairs. :if tf a applicant is;e�meg�ie,,;
<br /> oilier.tharY#Fre`:owner's t;ceit,`,{{:��,,tt attil.is rOf'Ra 'ii it�wcoly of the b6064esccitiedyrlaci�men#'and,Rrom se`in:goof!faith to ` '
<br /> t a" s v7- py.
<br /> deliver;i#:to#he;".owrie 'priar•_ao commencQm'ee :; .
<br /> T. G= R: tC?t1Y'ER.SwAI~ .i IT F�F ;that !>#tje inforinat'on an,this,a ligation-is=accurate and:'thart'ati=,iiiork'`-
<br /> CON, 1. .T0 C},' ! ttijt. ..>ai. _.f.,., I?P.
<br /> ,r.. }`F- .d. •-rF:•`: ,r..:.F'..,,;, 'L; .�.; 'r.. .:�'{: ^a,r,i.}.F_�•r }. .�F'Y::;r:?j:its t'ai+ ?^r
<br /> will'oe done:!n'compfiance"i'dW a�i::app"lica e';aws re ulajt n consfruc n , onrn and:land deWetopment. :Ap iticatton:as
<br /> .neret y made°to .o tain.a°permit.-to do-i iwbtkv4 disint aila l.certify. that no`�work"or.irist`allatioii4has
<br /> corrimarcedprior"ta:�issuance>:;af."a;;Permit onto) #haft:ail.:work•vulii be,;perFormeit tgTMmeet standards•of ail laws:regulating
<br /> F,^ .v?,, i.,_ ,,. .f,. ..�^t:!r;° G) �: _ ';T;,IP+:yi.' _ _ 'r'
<br /> r... •
<br /> constl'uafion;,t6i'Unty`and'-, �cia 643,zoning res fictions;anrl•:lands,de lapment:regulations"in;the:'jurisdictio'ra,...� I,also r,
<br /> cart!!~that i understand:that the,regulationso#-other gaveri>ment=.age ices,i�n4iy appiy_-.to.:the_Intended.wort, and�that it'is
<br /> my:responsibllity 6-:1denilfy„who#actionsd[mus#tai e:to`be;tn-compliance; ucij'agencies='include utare.not iil►3i ed,tjq;.
<br /> Departertent:of Environmental ratection=Cypress: Bayheads;"Wetland.Areas and-:Ei vironmentaily Sensi4ve
<br /> ,.'Lands;'Water/Was#.'ewat$f<:,�tea,���r#t.,.„•;��,-. : . .. � -
<br /> Southwest' Florida. 'Water` Mah4a' e•m�ebt`�¢DittricfVUells�''`C`ypre'ss 'Bayheads,. Wetland Areas; ''Altering
<br /> J..
<br /> I
<br /> Watercourses:
<br /> Army.Go'rps of'Engineers.Seawaj�s t socks Ne,+jdableiWatervuays;
<br /> - Departmente of;l�ealtti"�-1 teih,_fiilitative SanrjceslEnarirot�r�ental�Heaitt��kJntt-`Webs, Was#ewater'=Treatm.e�rt,:. :
<br /> �
<br /> iLxS Enviroian a tat;l?r to ti . � t YtAs �$to ,ab item-pt,.;::G
<br /> : r FerteFal aviation Ai tl oti#jr�t UR-w-"aya
<br /> urtiderstand'.1hatit ollpwirig testricttc is apaly,.to;the ses4fafll
<br /> - Useiaf#iti='is:foti ai(oiived fib: ii'one."V" niesa=oxprvsslyipecmitted.
<br /> ... ,
<br /> If ther#iIF~material�i , to;ge;;use i• n Mood 2orie°A°;'"it' bill rsfood�tltatr,a.�drainage•,plar-'-addressing-a
<br /> romping`M'volfrriew11t4►be"jsuliiii tied:at tirrer.of permittin g'.wiaioh;'is prepared::by:a:'professional:engineer
<br /> . ._.. : .
<br /> -licensed bylh- State of .onda:' :
<br /> .>f the'fill teriak is to be used-,.irt:Flood:-Zone,,�Ai�#riaconnection-with-'a permitted-building using.slena,EWORi ,_
<br /> cbonC'�ce faatfilfi-:viitt<te ::se± onlyfo;fiiltFaeareaswlxhiri,ttie_stem.:�ni
<br /> all,
<br /> ..
<br /> "' If'fill,matetiat i's'.to ib'e bisect:itti:',arry;,a a;: i ''cleft€y'•that�use of 'such fiilNwiil~.nofi°adversely affect:adiacent"
<br /> ..:... .
<br /> .,-..properties:-ft us'e::al�ififill oA0 toad erss ::jiff ,,odjacel,Lpropertlesl;:th.......,.wner_ ayv:be,:cited,tformio]at r g.
<br /> the coriditioias of"#fie't eiicting.:peti IVis"snett-.uric'er:#i e�attophlb, per&WAppiicatioii f6r iotsless'than'ohe'(Ty,
<br /> fi
<br /> acrewlatct':ere-0 it -1 le►?9iitie red tl"r is gacplart iSC .tequi�ed:
<br /> -If -1�THE tit R`:l� ` r i."is in: oo EIld f'1r�frirtxtA a ois!t er;o�:the•:pertr�i RV,—cQnd!.iQ. setfortii;
<br /> this::off±davitprior,to:;commienc'in`' const coon; l:un.'derstinr>'31at':a se(arate':'permit:'m'ay`be`requiredfor' lectrlcal work;
<br /> piurntiing;:. tgns,pwelis, pools;=`air;'c of ditioiylnQ;;; as:or-other l sle!ta#1 ris ot:6peclf1caliy,)APluded.•in applica n': q'.the_'
<br /> per4mit rssOle_J9111ae construed,,to:be:a:licorlse to proceedrw+ftt;the•wortc-and riot as authority tom,o I" lif cancel,~alter., of
<br /> setsastde any provr o(ts"of�the tecF.ni�;la dudes nor:shall:iasuuance of:a permit•prevent'the•Building:OfficiaFfrom thereafter ;
<br /> regitirirrg';a°MARectitn of.ermrs;in`,pian's,.consfructroncor violationsaf.any=Eodesr Evartr permit issued shag#l�ecomexinvaitd:
<br /> unless the work;;sulfrorized;tiy,sueh.ps r'It is;commenced ihithm six,months of.permit:issuance,,or if work':authorized„by
<br /> e ert�iit"!s scisperided ox abantior a or.a ei od of six(6}`iriori#h's fie the.timotWworkys commericeci::.:An a to"nsion.
<br /> msiywbe c�eques#ed;;tn writing,,from:'.tie B,uiidrng Ofha a7`.for, ' period:not:to e�rceed.ninety.(90).days antl will.:tlemonstrate._
<br /> 'iisfifia `le cause'sfo'#te`eliterisii''l µnor''`eases for nnet' )4coisecutive days"#he.job is considered aban`doned';
<br /> W `RNING,:TOrQIIY, ER:;;a;.YA,IJR;f' ' t;lRE`:T4::=RECORD.:A.tVOT10E 4F QMMENCEiN NT'.MAY::_RES;I#I:T;;IR,,,�F„Osi R
<br /> PAYI1►fttxtlE� ' 1Iyr�iT, iS�'!~? ..1dUt7uP'RRfJPE F n{., F YiO+ .�'I:4'OSAtNEIt!t�11�1 g ,C/y'y,J�tT:
<br /> --i�'�0"i'���U :�' "��-'4�IC31�'•�:�At�i�,�ciffor'ItY�i����IEaRE!1.K2�.iN.CvaY�3UR� -s: C-4h�!lEdl�le�C�V1ltENT. :. - - . . . -
<br /> OWNER•; pp'q N: ;r;:w; 1:.;:=z ,CiNTR14C:TOR
<br /> Sutisc►ibed:: pi > a. ): r�!..
<br /> f is _f. r� i 'JI F n - •? r 3 e..
<br /> Who is/are p onaliy."known to ine or'fias%have prodded'` ^ 1NIib'i /are p oriRirykbvdn'to'me or`has/iiave'`p`roduc"eti'`'
<br /> asidentficadon. 1
<br /> Notary Public Notary;Rubiic:°.r
<br /> Commission No. op1No
<br /> oaripptitNameofiNotarytyped;-prineostmped- NameoNtye _oraAd
<br /> G�Yf
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