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<br />C(jt, ))1 T 1 Ol~tl lW PElt...,
<br />
<br />.1"'" llH\V 11
<br />
<br />(L ~rrUGE OF DEEO REH.lnlcTIO"l~
<br />
<br />Ihe undH,lgned undenhnd, 'hi' '~h fUI\U lIy h IU~II[' to "deed 'UhlcUI/fai" IIhl'h ..v ..... .,., I . I' 'I [
<br />. · ,Uo;- v t In nt lYe "ill Ily
<br />regulillOlli, Ih. undtnl,ned .nulu fliJIDII'lbIlH, hr H"pll.IIU IIUII .n~ 'ppllu~l.dnd .uhhHl/n.,
<br />
<br />u. U!'!LJ UiliSED CONTRBGIPl1Y AND CQNTR8r.TOn RESPO"\i"JJUWlirn
<br />
<br />If 'hi e.llnu ~u hired · untruhr or cl\n1r.~hn h underhh ""',. 'hlY .., be, 1.."lr.' '" be Unn"d In mo,d.Ble lIilla
<br />II.le illd local ref)ul.IllInl. It the con\'~cl., I, n'l IIc.nl" al requlJ5' b~ I.., ..Ih Ihl aMntr .nd rIlAlr,c'II' "y be
<br />rilr~ for a 11&lluunl/f vlohtlon under lI"l. h., If 'h. IIl1ner'lIr h,hnded unh.ctor lI. unu.hh. n h ,,1I.l "'11".1111)
<br />requlrelenl. ~a1 .pply fllr lht Inle'"J!d,~or~, Ihe, .r. .dvl,ed Ie. [lInl.c\ I' J CII, .f leph~rhllll Bul:dln, ~ep~"I'h' IBlll
<br />101l-UII. " '. . ,
<br />
<br />fur'heJloff, I' 'h. IINr,fr tin hired a rlllhuhr .r u~I,.ehn, h. I, .dvh.. I" hiv, 'hi cllnh"III,hl II,n pO.UII',. III IIle
<br />"[on'r.'lor 5ec"on,' of 'III, .pplleit'~~ fllr IIhlc~ Ih.y 11111 b. re'p"nllbl., If,y"u, " Ih. "lInlr II,." the cllutr.cillr
<br />Yllu an i~dlu~~n, lhil Y"U, .u'her H"" 'hi UlII,.Cl.r, .re rnpI/nllbl' hr 'h. ""r_, If U,. unlr"I", Ithhu ~IIU I, .i~1I
<br />n nnhul"r 'ha' "y be in IndluUu r~a' hi h III' .r"'trl~ Ih...". If" h ".1 ''''''h' I. p."IUh" p.IYlh~1:S i" ",~
<br />[il~ lIf leph~~~llll, '
<br />
<br />C. TRANSPORTAT ION I MPA(~L FEES AND lJT I L J TV C{1NNEr.T I QN FEti
<br />
<br />f). CONSTRUCT ION L I Et'L!:JjH C CHAP!ER ? 13. FlOR IIh'\ STATUTES, AS AMENDEI>)
<br />
<br />I cI,II'y that I, Ih. appllcanl, hive bll!n provld.. ..alh.. topy of "fl.rl_,', t~~,',uc'I"n LI'n LiM _ "'I'II~ntr'. P"ltcli'lI
<br />Guid," p"pir'~ ~y lhl fl.rld. Dep.rl..n~ ., A"lrullur. and Clnlu." Afl.I,a, 'f Ih. 'ppllri~t la .....~. I'~.r '~In Ih.
<br />..~ner', I c.rllty 'h.t I h.ve '~tilned a rD'y of thl abDVI d..crlbld dllrUI,n' Ihi ~rll.I.. IA ,lIod 'il'lI 10 dMllvl' il I~ Ilot
<br />'lI~ntr" prlllf '4 coalene,.ent,
<br />,
<br />
<br />E. GONTF!f\CTOR' S/OWNEB..:!!.1\fF I OIW IT.
<br />
<br />I certIfy lhi' .11 Ih. Inf"rulllln I~ ",', :ppllnUn " ueuu'. ,nd 'h.I 'II .."r' IIIUh d"", in CUpUU.Cl ~ilh ill
<br />i,pllc.ble I'~i ",ula'ln, ["nilrUtt\~L, J~~ing, .nd a.nd dive'opaen',
<br />
<br />Appllullon '" hereby ud, h IIb"ln a ~(.fI1l to.. ....k .nd Inlhlh"u.. Inlluhd., !.ur\if, H,.t nil n,iI .,
<br />in.'ill.llfln ~.~ coalenred pr~lIr to If5U.ICt of . ,.r.II and 'hal .11 we.r. lilt' ~I ,tr'"rotd 'II oeel .Iihdi'~' III .11 li~~
<br />rll)ul'linf) r~nfit,uflion, Clly cII~el, \lIni'g r'9ul.II.nt, and lind d'VIIIIP'III' rl,ul.II"n" In I~I )u'~'dlrlilln. I .1111
<br />terll'y It,al'l under,I.nd 'h.' lh. rf9ul~IllIn. of .Ih,r ,,,vlrnlenlal .,er~Ifl .., 't,,~ to 'hi Inlthd,' MI,k, ~nd '~.I it i,
<br />IY ruponllblllty It Identify ..hal iCthu , .u,' hh \II be In n'pll..,c,. S~cb 19tf~~" ",'Iude ~lll 'I' lI~l i1lihd I~I
<br />. ,
<br />
<br />~
<br />
<br />t peputaen\ pf Envlron"A!!1 Re9!illlln .. ~ypnn "~hud" Ne'hn4 Ann In' rnvlfin"n'hil~ Suslli." liI.d"
<br />V.lerJVa,t,llalc" 'reit.enl
<br />I ~ullllle1W~jd. Vi"f "iniqu!!1Ll1!lrll1 . Wllh, Cnun B.yt,ud" W,Ihr,d Arn,,'Alhrlr., Ih"rCllUrlu
<br />· 8(!Llll!.L!...'. Englf,errl - 6UlliI", D\tnt, "lYl,a~" Wihniy. . .~. , '
<br />I D~pi'henL!.';_"'tum L Rthib"Ud.!u...i![]1U', rnYlronunhl 1t1!!l.ULY!l11- il~"'. ""hllah, Ife~"en', S~ptlt hnk5
<br />, ~U!!lir"lI.tv\ i Uil.!!1lil>p l\'Ienc{ - All fl.l.. .hhltnl . 'I ". ,
<br />
<br />'1 aho urtlfy "l.I, If fill u'r:rhl Ii to be uu. an Fr,,04 l"M "A' .r 'Al""~' It h undera'lI.d 111.1 . dl.lll.ge phil
<br />.dd'~IIln~ · 'rlt'ptnll'In~ vIIIUI." wI" bl .ub.ltl.' IIhlrh I. prep.,.. by I ~r~'I,'I.nal 'nf)ln~e. re~i'l~i~4' i~ Ihl Slile ~l
<br />flo,Ida prlllf I~ per.II I.,uinCI. ,
<br />
<br />,I
<br />.
<br />
<br />.
<br />II peril' I.Iu.d Lh.l. be ronlt,ued I. bt . l,c.n'l ,. p'lcled 1I1th 'h. wllr' an' AliI .1 lulhllrlly III vllIl~l.; (.nc,l .lllf, tl
<br />lei a.lde .ny rrDvl,llIns IIr III. technll41 t..~." nor ,hall I"u~n'l 0' . p~ral' ,riven' Ihe lulldl1l9 Urrlci.. II~' thtfe.'lll
<br />Hquirln, . u.uctlon ot erfllll In pl~n~, un,truclln, IIr villlil''''nl flf Iny Ud., hery P'flit iUIII!~ il..." betu. ifl'/.lid
<br />unleu 'he Nork otu'hllrlud by Iucb perl'~ Ii c.."need ..Ubln iii. aonthi i, luunu, IIr If N(,I~ aull,IIllle6 b~ the ~e"ll H
<br />,u'pellded ot lL.hdoned f.r · pe,llId or Ilij '~n'hl .rl'f Ih, tl., 1hl wII,k II [~..en',d. 'Olle ~o d't fxljn,i"lI 0' Ii." lit Ll
<br />.1I~II.d for 'II! perait ..IIh fee rhu,. II' : l~,OO" lh. ..hnll..n .hill h "~II.."d In lulling I" Hlu Build';I~ Offici.1. till
<br />iHrllved in5pedllln IU51 bt lll~f)ed during I ich III "'IIIh ~tr lod, Dr 'h. ,njct' 11111 h u..5Idertd "b~l.dllll.d.
<br />
<br />l~()RNING TO OWNER. YOUR FI\lLURE TO RECORD A NUTICE: OF COMt'lEI-Jt:EtlENT 11fW
<br />RESULT IN VOUR PAVING TWICE FOil IMPROVEMENTS TO .VDUIl PAo.P.Ell1Y. -IF 'lUll
<br />.. INTEN() TO DBTA'IN'FIN Jet!\)!:), CONSULT WITH'VOUR l-ENDER on I\N,I\IIOllNEY
<br />DEFORE RECORD I NG . UR' N lICE OF COMMENCEMENT" JUBS, UNDER "2.500 1 N VAlllE
<br />00 NOT NEED T DRD A . PO "r;OTICE OF COMMENCEMENf" "
<br />
<br />
<br />SIGN"Tlln .. . BIONAT':nE I ~..L-
<br />n --"'---iiW;Eii-iin -------FJEj ;,.;;::;:;. - -----ciiiiTiiiicTiiii-~ - ~
<br />I DATE____J.2.._"".LQ____C/..5.>..______ ~__'__ ___________ DI\TE_ ------J.2:.:L9_:.5_3______..______ _ __
<br />~~~~:v O~B A~~NT~~~- ~~~~=~c~~n~~-_c~cJ"~
<br />
<br />MY COMMISSWN ExprnES_____...._~,. ._______.____ MY COMMHi3101i ExPIAEa.;.~_,_.!.'.1.:.:.;.".._____h_.
<br />,i " ' t , .; .~ i',;,. ~ "
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<br />
<br />~
<br />
<br />KATHt.EEN J. BROWN
<br />State of Florida
<br />My Co. mlr~ Exp. April 2, 1995
<br />CaiTlM. II CC 095&17
<br />
<br />
<br />KATHLEEN J. BROWN
<br />Siate of F'orida
<br />My Comm. Exp. April 2, 1995
<br />CamM. II CCO';5~'7
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