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<br />J UL -L~- "::U MUN U: 4l::l Ill: r..; I I Y U~ Lcl-'HYHH I LL~ I cL f'lU: l::l U '(l::ll::l ,jd':;l,j
<br />
<br />l=I~~d I-'ldd .
<br />
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE pF DEED RESTRICTIONS
<br />'1~;u~~~~~~'~II:D!'..t:~!~~!"~!.~!~ r!~~~..~~r. ~~ ,'~~~I~~_~! .:~!!d ,,~~~t~~.~t~~~~: _~~~th .ay lit 10ft t"trlcth. tbln Cl ty
<br />
<br />B. UNLICENSED C~NTRACTORS AND CONTRACTOR RESPONSIBILItIES
<br />If the ,.ntr bil hlf.d I tontractor Ir contrlrto,. tD underta'e IOrk. lhty ..y ~I reQuired tD bl liclnsed 'n acc.r.lnet .ith
<br />5tate and IICII rltul.tions. If the c.ntrlttDr is not lie'D1ld as required by la., both the owner Ind c,a'r"t.' IIY bt
<br />[it.d fDr a .il....l~r ,illatlol Inder stat. law. If the own'f Dr intended contract.r Ir. uncert.ln II to Ih., tlClnlinv
<br />'e~ui,e""'. .., .~,IV fir 'hl IB\Ift4.. MtPk, 'hi? If I Idvicod to tontact thl rltv nf 7lph,rhllll Ru'ld'RO Ipplr'lIn'. IBllt
<br />788-UU.
<br />
<br />Further..r,. if the Dwner ha, hirld I contrattor or eDntrlr\or~, h. is ad~lsed tD bay, the cDRtr.ct,rllt Il,n pDrlionl of the
<br />"ContriC'or IlCti,..' If this a,pli~.'i.n f.r which th.y ,ill be responsible. If YbU, as the .wnrr 11,. .1 thl contrlctor,
<br />YflU art In.UuUJIV thd y,a, nther 'h." 'he L.UlIl,...Lv" 6re r..pan.i1,le f6t' .". III"k. If ,". tOntradDr .11hK you to liVn
<br />as contrlctlr thlt .ay be In indication that ht il not properly licens,d Ind is no' Inti tIed to p.rlltting pr1vll",. In thl
<br />Clt, .f Ztphyrhilll.
<br />
<br />c. TRANSPORTATIO~ IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />O. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />1 e.rtify that I, the Ip,lif.,t, haYI '"n proYid,d .ith a tlpy of 'Florid.', tonstruttioR Lien III - HlIIDIDIf'I Pr.',ction
<br />SUide" prep.r,d by the Florida Dtpartllnt of Agriculture and C,nsu.er Affllrl. If thl .ppllClnt II ....... other thin the
<br />"o.nlr", I certlfy 'h.t 1 hive obtained a CDPY of the .bo~' dllcrilled d,cu.rni and prl.ill In tODd f.lth t. dlll'lr 1\ tu the
<br />'o.ner' pri.r ,. COI...,.nt.
<br />
<br />.' e. CONTRACTOR' S/OWNER 'S AFF 1 DAV 1 T
<br />I t.rtify that all the inforlatiDn in thil IpplicatiDn is atcur.te ind 'hat all .Dr. .ill bl d.nt in tDlPlllntl with III
<br />applicable II.' ,elulating CDnstructlon, zoning, Ind Ilnd develop.,at.
<br />
<br />Dpplir."nR t\ bPf~Y I.dt \D D".in I "rill " OR worK ,nf i",.,llltlDn as lndlcat,d. I tertify 'h.t PI ,bl. or
<br />instlllatiDI hal tllllftCed prior tD issuant' Df a per.it Ind thit all Mora .111 Ie p.rtDrlli to II" l'lndlrd. Dr all I.w~
<br />r"ulating cOnltruelieD, City cod.s, loning r'gulations, Ind land developltnt regulations in 'hi Jlrlsdlc'lon" I .1'0
<br />tlrtify thlt I ,".rstand thlt the rtgMlatlDns If othlr "..rnl,olal Itinti'S lay apply t. the In'..... IIrk. aftd tbat it is
<br />.y r.s,Dnlibllit, tD identify Vblt Ic'i,nl I lUst tak. tD bl in cOIPIlanct. Such Ilenti,. includl bat Ir. not Il.itld to.
<br />w h".,lnDl uf Ind,v._lIl.1 R.,ullthn Cyprell Dlytle"., W.UI. ^re~1 and Snvinnnnhll, hnliti.. Llndl,
<br />later/UlstIWlt,r Trlatlfnt
<br />I ~U'h'II' Fllrid, I~tlr M1nlDDllnt liltrift - Willi, Cyprl.. Alyh~ad;, MptlAnd Ar.al, Al'.ri.O MI'tr"lrlll
<br />I A.., Cu... .t Elll"I" ' UlIU'lll, .Ie.., M.vl,.~11 11\,r"a"
<br />I D art...t If bun. ive S r EnvlroJIIlnt
<br />. Enyirlnllntal 'r.ttctl.. Aa.1tl . AlblstDS Ibate.ent
<br />I also certify that, if fill literial il tD bl used ln FIDDd Zlne -A" Dr "A,tt~.', it il under.tood th.t . drllntg. pI In
<br />addrl51inv I -colpenslting volulI' will be s~.itttd whith 1s pr.,ar,d by I professional .ntinett reglst,rld in thl Bt'" of
<br />Florida pritr to '''lit i,sulntl.
<br />
<br />lth UBit - Weill, Nastllatlr Trlltllnt, Septic lank.
<br />
<br />" p.r... U:HIII.J :.1,..11 1,11 LU...l,..J l" ~. . ll....... lv 1" "....J ..: 11, 1I.. JU' AU .d II lu'k.,U." ,. ,ilhl.. lIocll lit". nr
<br />set aside .ny provillens of thl '"hni(.! codes, nor Ihall i,sUlnte .f . p,rlll prlvent tA' IUll.l., Offltl., fro. they..""
<br />requiring I c.rrictiDn If errors in pl.ns, (Dnstruttio". or violations If .ny code. Ever, p.rllt ilsued Iblll 'It'll Invalid
<br />unllss the war' auth,rilld by luth pef.it il co..ented .ithin six .inthl of llll.nel, or If ..rk luthlrll.d by the per.tt II
<br />luspended or abandoRed for I period of six IOnths Iftlr the tilt thl work il cO.lenced. 011 90 d., ,.t'nll, tl.., '.Y b.
<br />.llow.d f.r thl p.r.it .ith fe. (hlr" If '15.00. lh. Iltlnsion shill bl r.qulltld in .ritint tl lh, IIi I Offltl.l. An
<br />approvad inspection "It b. IDIIId dlr'nt 'I~h Iii .Dnth period. or ,ht prDilet will be tDftSldtr.d a
<br />"ARMIIIS fO OUMERI ,GIll FAll- TO REtURD A MOT ICE Of l:UMtIl1.l:IItIU lit, KttiUL III YOUR PAYI. TI I
<br />PROPERTY. IF YOU INTDD TO DlTA1" FIll_INS, toII&U\. T IIITH YOUR LEMDER ATTDRIIEY BtFORE ..
<br />C_IUlDT. JOIS UIIDER '2.500 lit VMoUE DO NOT NEED TO RECORD AU "MbTlCE OF
<br />
<br />&11Wr'UI!I _ ......
<br />
<br />
<br />STATE OF FLIIRIIA
<br />CadflY OF
<br />The foregoing inatrument
<br />before me thi-
<br />
<br />--
<br />WiI& acknDwledged
<br />, 19_ by
<br />
<br />STATi
<br />tuTY OF Pn s~o
<br />The foregoing instrument was acknowledged
<br />bllfore me thl& July 20 >, 19~ by
<br />
<br />Gregory P. Johnson T
<br />who Ii p,rsonally known to me or ""0 h..
<br />prc;,duc;ed
<br />.s iden'ification a
<br />tak n Dath. ~
<br />
<br />(Signature)
<br />Susan S. Autr
<br />(Name , Pr JoU~~IiF.1StaNMmRdld )
<br />NOT U SUSAN S. AUTRY
<br />My Comm. Exp. Nov. 7. 1995
<br />Comm. No. CC 159125
<br />
<br />
<br />who is parsnnallv known tn me ~r who has
<br />pl'"ottlll':'8d
<br />~s identlfication end "ho did/did n~t
<br />take an Dath.
<br />
<br />(Si;nature)
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARV PUBLIC
<br />
<br />
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