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<br />t1AR-18- , 94 PR I 15: 12 ID: C IT\' OF ZEPHYRH I LLS TEL r~o: 813 788 32'33
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<br />,- .I\V ...,' .... .(
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<br />CONDITIONS OF PSRMl~ AFFIDAVIT
<br />A. NaTICH OF DEED RBSfRICTIONS
<br />ftI UDird,... "taI'taat till. perlit II' be .uhJecl to 14. r..trletlODlI .bleb II' be .. rtltrlctlft tbu City
<br />regulatlCIII. !lie ....1_ ..... rllpcuJl)lllty for CCIIp!Janca IIUIt aD, eppUClble 11_ ratrlcUa.
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<br />B.UNLI~8BD,C0"1RACTORS AND CO~~CTOR RESPONSIBILITIBS
<br />If the OIIIIr ....'bind . caatractor or contrector. to unnrtUe work, tiler.., be I8Q111red to JatUctIlItlJ iD ICtlOl'UDcI wltJa
<br />atate lid local replt.u.. If tbt CODtraCtor is DOt llC1D1ed II rBqUlre4 by laI, IIotla tile ... .., CXIltnctcK III be
<br />cited for 111__.. ,1011UOIllld48r etate 1... If the 0III8I or Intended COIltractor Itl UICIrtIJa II to _t llC1111int
<br />reqolr_ta .., lIpplr for tilt latlal1ed IOrll, they are e4Yi.1cl to coutlct the City of lepltrrbl11lltalldlDg ....-t, (813)
<br />718-6511.
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<br />FurtIImDrI, If tbI ... bu bind I c:outIlctor or cootrlctor8, be II adtlaed to ba', the lDltncta.r(I) 1111 POCt1GIlI of tH
<br />lCoDtnctar 1ectlaDI. of WllPPl1caUIIl for Iblcb th8f will be rllpcllllble. If JOU, . the .. dga II till atrlCtOt,
<br />JOlIIII IaIlcaUag tat JOU, r.tller tban the contractor, Itl tIIPCJnIlble for tI18 worl. If tQ ClIlDtrlCtor liIIMII JGII to .ip
<br />.. CODtrlCtDr DIIt ., . III IllUcatioa tllat be Is Dot properl, Ucaed an4 11 not enUtllll to puaitUDg prlri1lgtl1a tile
<br />City of lepIIrr.lll..
<br />
<br />c. '1'RAHSPOR'lATIOII IMPACT FEES AND UTILITY CO~SCTIOH FSBS
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STA'1'UTBS, AS AHBRDBD)
<br />I cert1fJ tblt I, till ....UCIDt, lIbe beID prOYl4e4 11th 8 COPf of -Florida'. QIIItructloa Lt. .... . -.em.,,'. PtotICUfII
<br />GuiI1tI pnpereIlJr till rlorl.. .tIeOt af Agriculture aDd CooIWIet &ffam. If tbltppllcut It .... ok tIaIIl till
<br />IGIJIII'I, I certlfr tIIit I... obtl1ael1l copr Dr tIat 8bcm I!ucrlhed docuIeDt IIIlJ pr.... ill goad fa.ltla to Wlnr it to the
<br />ICJIfDIl'I pdor to tlCl.ln~t.
<br />
<br />E. COJrIUC'lOR' SIOWlfBR' S AFFIDAVIT
<br />1 cartlfr tIIIt 111 tIIi" bloa.Uoa ill ~. applieation I. accurate IIKl tllat all _t 1111 be lbIe II CGIp1111DCt litb .11
<br />app1JCIb1. 1_ -.UIg ...tnctiaa, 1OD1bg, _ 1_ GI'llopl8llt.
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<br />Appllcatlaa 1I11enbr .. to ohtlia I penlt to do IIOrllDd iDlt4l1aUOD 81 1D4Jeatll1. I certifr tIIIt lID IIIk or
<br />JnsWlatt... ....<< I" prior to IIIIIIDCI of. pemjt aacl tbat all .-k .wile pufol'llld to _t ItII*rdI of 111 1_
<br />regulaUog CGMtrDcU., Clt, cae, lOlling regalatl0D8, IDllIID4 de,.IO(lllDt rega1aU.... II .. juWlct1.. 1.1110
<br />eetUfJ that 1 IIIl1enta tIIIt tM regalaUODI of otllu got_tal aglDCl. III ., to tile JaUllW _k, .. tUt it II
<br />II reapalbllltr to lGellt1fr at KtlODl [ IlIIt toe to bill cmpUanC8. 8a egeoct.. lacl1ll1l lilt III DOt 1ll1te4 to:
<br />t DePlIblqt of IDYl..... ....Uoa . CfPr.. BarHada, Vet1111d Ifeu IIId Intlt,oa_taUf ....u" Lu1I,
<br />. IIItH/III.tel' lree_t . .
<br />I SOUtMIt rloddl liter _....n DJ~I~t - IIUI, Cypna Ii"", IIltllDd It_. Ilterlng IIt1rCOllilM
<br />t .. "'11, DDcU, IaYlgab1e llatttlllr'
<br />· IIlIJr.-tI1 Bea1tJa UDIt - WIll., hlt..ter rree_t, 8eptJc f_
<br />IUS . IllllltoIlbat_t ,
<br />1 .110 r, tIIIt, If flllllterlalil to be uaed in '100d loDe IA. or 11,lte.', it 1. undentood tIIIt a ar.. plu
<br />dnabg. .......Uag _.' Illl bfll1IbIlttec1vUcb I~ prapare4 br a prof...JOII1 eaglDtlr ngletetec1 bI tM Btlte of
<br />florid. prior to _t .....
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<br />A pen1t IaIId aU III mutrued to be . l1clJIII to proceed 11th tile wort end DOt II lutllJrltr to tlollte, GIIICI1 alter, or
<br />at ..lele IIf pmllJ.CIII of tM taotw cac1u, DOl M.ll luUIDca of . penit ptlJlI1t tbe IIUJ41Ig Offlall1 fa tMttafter
<br />reQUlrlDg I CXJrnCtb of errors lD pl., COIIItIuct101l, or 'lolaU088 of ., caH. hlIJ' pIrIlt ll1U1lJ IbI11 ... lDYal14
<br />unl... u.e allUtllDrla4 br IU~ penlt i8 ~CII1 ,IWn ,II_till of llllllDCl, or If lOll autIIotbelJ bJ till pm1t II
<br />.~ or IIIIIbIl1 far. puiaG of iii utili aftII' tbe till tile lOll Is ~""J..c.'Il1. Gal 10 .., _.1. of u., .., be
<br />al10111d for till ptIIlt Iltll fu cIIIqe of '15.00. IIIe atIDIlonaH be r~ in vrlt;1llf to tllllII1W1g Offlelal. AD
<br />epprond laIpecUaa.. be 1_ _log _ Ibath PIllod, or tbe project will be caUInG .....-1nIItIJ. .
<br />1fIII1. to..: 101I PlIUII ro IICOID IJOIICI 0' ~WI MY Rl8ULr U IOUI .lIlR IIICI JOI ~ 10 1WI
<br />IIOPIIII. IF IOU UIIID 10 CIIWI fIIIICIlG, allULI mil 1OII1rIIlJIll 01 III IIIOIIIf BIFOII ... JaUlIOIICl Of
<br />aIIIICIIIIf. .... '2,500 II ,ALtI 00 DIDO 10 IlICORD AID POS! I '1Of1Cl OP ~"'I..
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<br />The foregoing 1DatZ'U8Dt v.. acknowledged
<br />before _ tbl~cX~~ , 19 PY by'
<br />
<br />g~~
<br />
<br />who is perIOD ~o .. or who has
<br />produced ,__ .
<br />a. ideDt:Lflcat1aa IIDd .ho...."'''/did Dot
<br />take .. oath. 1I>\J U"''' I' .
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<br />
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<br />:Qlylt...u. \ ,
<br />: : June 12. 1996 :
<br />S, \ No, cc 1'" !v
<br />'\ \S\~" '...bUS\.\(i ....~~
<br />.",,:'1)o~""".'.'.O~
<br />;""", OF f~ ~
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<br />II"!URI: CDIIIIC!CI
<br />
<br />R..-?-4.1 '
<br />
<br />StI!1 or PLC!!1D! ~. . \
<br />coom OF ~
<br />The foregoinv iDltl'1lllent v a ackDOIIle4ged
<br />before .. thi.~ :l Y , 19 9 If by
<br />
<br />~~J ~~.~
<br />vIlo 18 per8ODal~ lmOlfD to _ or .Jio~b.1
<br />produced --#~-
<br />.. identification and who ~dld not
<br />ta"e ..... oath. -~,..."'~
<br />A ua. 7~~/ ~~. '1. --=
<br />(s!gJlat.....) ~i ..... O"U,Q...., ~
<br />Lffrr-Y :"~-GfL.t;~ ' "-
<br />(Rue 'l'yped, Prlnl :~!'!1~:1) :~
<br />NOTARY PUBLic ~ \. ~ d:2i~7 j ~
<br />%,\S\,.;.... .bUSL\C ...._~ ~
<br />~ ~~" ..,~....., $'
<br />"=',. '~ .......... or ~
<br />~',III OF f\;.: """,..
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