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<br />A. ~OT'CE OF DEED nESTRICTION~
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<br />lhe undersigned undershnds 'hit 'hh penH I.Y h IUUec' to "deed rtlihlcllllrl'i' which uy be 111ft ruhi'Hvi \I,ell Cily
<br />reguliliohi. Ihe undtrslgned .iSUle, responllblll'y 'Dr elllpll.l\ee wi'h .ny 'pp,.~.~le d~ed rtslri,Iillns.
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<br />B. lJNL J CENSED CONTRACTORS AND CONTRACTOR RE~PONliHH L IT I E.li
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<br />I' Ihe IIvnfr hil hired I clIn'rlctor or tontl.~tor' al undlrtlk. Nork,. thlY IIY b~ "quI,.d'" ,bllleensed 'In i,cDldince Ni'h
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<br />sl,Ie ,nd lOCi' re~ul'IllIns. If Ihe tontlittor II not Iltensed is I.qul'.d 'y li~, 'oth th'o~n" Ind lllntri~t~r .iy be
<br />tiled for i I"duunllr vloh"on under Ihte hll, If 'hi Clllnel'Clr inlendld ton'iUt'"r irt IInurhin u h lilia' Iiu..iing
<br />r-equlruenh uV .pply hI the Intended wor., 'h'r In Idvhtd tll unlit' PI CI1y 0' le,hV,hllll 8ulldlng ,Dep"he"t, 181"l1
<br />1011-61.11.
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<br />Fur'herlore, I' 'he IIN~fr ~i' hired. cllntrltlor .r con"itt"'I, he II idvlled ,. hlv, 'h.,c"ntrittll'~st I'.npor'io~s III Ihe
<br />.[on'ri,Ior Sections' of 'his .pplititlon fill .hlt~ thty wli' bt re',lInll.'., Ii YClU, il tht IIlIner IIgn il Ihl clllI'ricllll,
<br />YIIU ire l~dlt.'lng 'hi' V"U. !i'her thin 'hi clln',ictol, .re ,esp"n,ib', '"I tht WII,.. If 'ht 111nt'ictllr lIi,h~, YllU III ii~l\
<br />i5 ",nlnchr Ih.I uy be in IndluHlln 'h.I ht h 'lot pnperly IItllllud iI.d Is rlllt .nUtI.d tll ptralU",g pr'(,hgts i" 11.1;
<br />[ily "t lephyrhi'ls.
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<br />C. TRANSPORTATION IMPACT FEES ANO UTILITV CONfr~CTJON FEES
<br />D. CONSTRUCT I ON L I EN LAW (CHAP:rER 713, FLOR IliA ,3TATUTES, AS ,AMENDED)
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<br />I cerllfy th.t " t~e .ppllcin', hive been plovl't. ,"h,' copy of 'florl_.', C~\~~ruc'l~n ~Ien Lill - H~.tll.ntr'i P'1I1kCli~"
<br />Guld," prepilld by 'h. floridl DepArtllnt of AgrlcultulI ind [oniullr Afhln, 1': \hlt .lppHul\t II 50""'" oU,u It.in II..
<br />.~Nner". I ter'Ify I~.t I hive ~bl.lned I ttpy of th. .bllv, d.icrlb.d dteulenl .~'~Itill' In 'Clod fillh lod.ll~ll il lu II,~
<br />'~Nn~r" prlllr 10 co..ence.enl.
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<br />E. CONTRACTOR'S/OWNER'S AFFIOAVIT
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<br />I cer'lfv Ihit .'1 Ihe Infllr'ill"n In this ~ppllt.tltn II iccur.I. ind 'h., .11 fllrk wlll'bt dt~f I~ c~.~llif'-t Nilh ill
<br />ippllc.ble laws re~uli'ln~ c~n51ruc'i~n, I~Rlng, .nd "Rd devetop.enl,
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<br />Appllu\lon Is hereby udt tll lIbhln I penlt to '0 lID1k .nd InihlhUu U Inlluhd., hffrt.ift ~1'.~'9~'~J.t: ~I
<br />inshlhUlIR hu tDllenud pr.IClr to "sunn I' . pllllt ind 'hit .Illl~rlllltl b. pfrf.U~dt~ n" sht.dir~lj III .11 1.115
<br />reguhHng constru,lIon, City u~n, nnlng nguhUtns, .n4 hnd dev.lllp'''" ","h'ltn., .n'" ,t.,ju~I~~h'.~". I .1511
<br />cerllfy 'hll:1 IIndellt.nd thit I~t regulatloRS of .'hl' 'IIvernlen'll 'gtr~ltl "y .pply tll 'ht In't~ded' wlIfk. ind I~., II is
<br />.y responsibility 10 Identify wha' itllonl I .us' ')h h be In cupll".t,. SlItb "tr~~1I helude bill ile '110' li,ilkd '~I
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<br />I PepiI hen' IIf Envlronltnhl ReQuhH"'l - Cypnu "Vhudl, Net hnd ArUI .nd ~:nYlrtnll~hl t'y 'SinSl II ~t lll.dj,
<br />Wittr/V..t'lIi'r" 're"lent
<br />I Sc.u'hllu\ FllIrld. Ilihr "'niQUent Dh'du. - Vtlh, Cypnu '.yt.eids, Veth,~ Are.ii, ,Mbrh.g Uile\,ctUUtf
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<br />. 6!!Y [lIfps Df Enqlr'ttrl - SUNil", DIICkl. "iV".~,. W.I.fwaYI ~ .', _, '
<br />I DfPirhenl lIf Hullh L Rthib"'hthe Servin,. hvtronaenhl HuHh Unl' - Wi':IS, Vnhlli'~~ h~it!el\',~,p'I' linh
<br />. US [n{lf"nl,n\.1 Prllle"'''n Aqency - Asbestol i~.'..enl
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<br />'I .ho certify thi', if fill uhrlll II to b. uud In Frllld 111M "A' tr 'A,'t.I,'t II 11 undenhlld ".11 i d'illuge plin
<br />.ddreuill~ . 'cupinutlng Vlllu,,' IIUI be lublUh~ IIhleh Is prep ired ~y i pr')hnh"'ler,~lr.(:fr re~is~~fl)d:' i.1 Ihe Slile ~f
<br />FIDrid. prlllr t" perait ISluint!!. I
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<br />A penlt luued sh.1I be conltrued to b. I. tlnnn to protttd lI11h th. IIl1rk and nllt II iulhullr III vi""", unnl illu, (.,
<br />itl nlde .ny provlsllll.1 of 'he hchnlul "'dll, nor shill Inuinu of . 'IlnH prenn' 'h. 8ulldlngUfflcl.1 flu Il.trtiJll:1
<br />r~qulrln, . uHf"lon of l!lIrlln in phnl, ClInl""t""n. "r vlllhtlon. .f any ';~d" Every ,,,tH issul!l1 itll;1l be,ue ill'lilid
<br />unleu the Nork iuth"rlnd by such pen" h un'AC,d NUhln 51. lon' hi of IHJince,WHlItI,L."HiflIIUil' ~l' Ihe ~e"i' i~
<br />suspended 01 i~i~dDned fllr i perl"d of Il,'on'hl .ft,r 'he tll' the IItfk 'I '~.Ienctd. 'D~"~~;d., e.'iri'~~d Df li'~1 '.t L~
<br />illlolled for \I,epenll .lIh he [hrg. ,,' $1:\.00. lh. ..tenil"n sh.lI "t IIqullled 'n IIfllingh ltl"'~IIHdl'll Offici.l. All
<br />e~proved Inlpec tI"n lu,I br: IIIqqed during uth I" ,"n'h per lod I Dr 'ht pIC/Ill(' 11111 h ",i..ider'fd~bl..dj,t'f-d.
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<br />WARNING TO OWNER, YOUR FAILURE TO RECORD A NOnCE OF COMMEUl:EMENT 11AY
<br />RESULT IN YOUR PAYING TWICE OVEMENHi TO YOUR"PRbp.~Rly.i IF YlJU
<br />.. INTEND TO OOTA-IN' NG, ITH YOUR LEND,ER PH AN, AllQf1NEY
<br />BEFORE RECORDI ,Y R' TIC OF COM NCEMENT, JOBS' UNDER $2,,50'0 IN VAUIE
<br />DO NOT NEED 0 RAND P A" !::bCE OF CLM'1ENCEMENr" ~ tJ
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<br />, . fk~:;~~ATURI: 1~1' p~/~~
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<br />OHNER OR AGENT CnNTRACTO~ '
<br />, DA TE______Lil__3:;_bl-:L::4_/l:::1i._=~-;.-~ATE- --_.!.f-l-~-P::'ii:'2.;;;:~
<br />~~~~=y O~s A~~NT ___~fX_~~h~_ c~~:~c~:~~~_.' ..."-_.\_~J_'~_
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<br />~\\\"'"111111', 0 I' 'lOr: . R ' .\1\11, "
<br />MY COMMISSION EXPIRES___~~-t!:~;~-_-__-_ MY C MM h1J NFXP~l ES,""~~~J~.~,~.#J/~_---___.
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