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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. HOTICB 0" DEI.D RESTRICTION8
<br />!be UD&uIIgDt4 IIDd8nt1D41 that fbl. penit IiY be .ubJect to 148811 ratrlcUonal Ibleb Ii' be lOt' rutrlcU" than City
<br />ngulatlDDl. Dt ~ItIJ_ ..lUlU rUpOIIIlbUltr for cmpl1lDce Mlth IDY applicable 4e8a rutrlcUou.
<br />
<br />B. LICSHSBD CONTRACTORS AND CONTRA TOR RSSPONSIBILITIBS
<br />If the OIfDIf bu t . CllIltnctor or contrlcton to undertake work, ther lilY be reQuired to be l1C1111ed III acmrd.ance ,lth
<br />Itate an4 local nguJaUcu. If the contrlctor 11 Dot Hewed u requ.lred by liw, botll tile CMW ID4 CODtnct.or II' be
<br />cited for. a114..IDOt yiolatiOll lm4er ,tate lar. If the ownar or Inten4e4 contractor are UACUtaJ.D u to wbat llcwlnq
<br />requlr..ta RI applr for tb8 InttDded IIOrt, they are add.ed to COIltact the City of lepb,rhUla IuU41Ig Deparbent, [813)
<br />788-6511.
<br />
<br />Furth.IIOf8, if t!II 0WI1' bas blred a coatr.ctor or contractors, be Is adviled to have the cootractor(.) lip portlO111 of the
<br />'COntllCtor 8eCtlllll' of WI appl1cat1oo for wblcJI ~er "Ullle rupclftlible. If JOU, u tile OIIIlU lip.. till aIltractor,
<br />Jog art iD4!cat1DG that JOU, rlther tbaD the contrlctor, Ire responsible for the IOrt. If the coatractor 11I1... IOU to 11gn
<br />.. cootnctor tbIt ., be lID 1ndJcaUoa ~t be 1. not properly Hewed and 11 not BDUtled to pmltt1Dg prhllegu 10 tJlll
<br />city of IIpbrrbl111.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNKCTION PEES
<br />
<br />D. ctONst'YC;t~9N LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AKBNDBD)
<br />I mUff tllIt I, tl1I appl1cent, have been proYldeO rJtlIa copy of 'Florida's CODBtrucUou LIID Law · ~...I. Protection
<br />Guidi' p~ b7 tba Florida DepartMnt of Agriculture and ConIUIU' Affair.. If the appUcant 1. DIOIlI other tbaJl tbe
<br />'owu', I cuUfy that 1 hnl obtained I copy of the above ducdbed &cwIBDt an4 pml1.8 In goo4 faith to dalhar it to the
<br />'ovner' prior to c:o-eD~t.
<br />
<br />E. CONTRACTOR'S/OWNgR'S AFFIDAVIT
<br />I wUfr ~t III thllAfonaUoa 111 W. appllcatlon 11 accurate Md tbat aU lfOrk wIll be doDe In COIPllance 11th all
<br />applicabll 111I rega.l,UDg caD*trI1cUDG, lOlling, _ laD4 dalelopl8Dt.
<br />
<br />Avplieatlat ia bIrIbr .. to obtain I plflit to do IOrk aDd 1l1ltallatian u indlClted. I carUfr tJlat 110 IOtt or
<br />inatallaUCIl baa ~cIl! prIor to Iauance of a pmlt and tbat aU lml wll1 be perforJ8d to _t .tID4IrdI of all law.
<br />regulatlnq COIlItructlCll, eit, coda, 1001ng regulatiOl18, and land defelDpleDt re9UI.Uou In the jll1'l84lct1oo. I 1110
<br />certify that I UDdarlt&Dd that tberegulaUons of othu govemllDul agenclu MY apply to the ints14e4 al, eD4 that it 11
<br />I]' rupaaaibUU, to 14aDtifr ,bat acti(Jl1l I Wit taka to be ill CDlpllIllCl. Such _ellS inel.. bit an DOt lWt14 to:
<br />t Depu_t of lDYiroallllW RequllUcm .. CypruI Barbuda, wetlllld Areu end In,troaaatdlr _1Un LID4I,
<br />Vatar/WUtlrat.r IrutllDt
<br />t So\ItJlwut Florida ~tet t District.. Velll, Cyprea. BarhIW, VIUID4 1ru8, l1tarlD9 htarc:oun8l
<br />. ... hnll I, DocU, latigable .aterva,.
<br />t 1lllah1lltaU" Bmleu IDvtlOllHl\tl1 Health Un1t .. VeU8, VutGlatu !tUtleDt, 8ept1c laW
<br />. CS IDd~tlJ II1lolDcY .. IahutOl ahlt.-at
<br />I alao certlf, tbat, If fill ..tarial 18 to be uH4 In Flood lODe I.- or -A,ete.., it 11 undentood that I dr.!DIga plan
<br />a6drtullg a I~Ut1Dg YO!\II8' wll1 be aublitted which 11 prepared bJ it profusioo.al englDII8I' reglltued lD ~ State Df
<br />Florida prior to pmlt lulW1ce.
<br />
<br />A pulH iuued ahall be COI1Itrued to be a license to proceed with the IOIk IIId not .. autbodtr to dolate, cucel alter, or
<br />let ulda 1Il1 prod.10D1 of the ttcbDlcal codea, nor .bal1118ulIICI of I petllt prIYent tile Bulldllg OfUc1a1 fRII tbena.fter
<br />nqulr1Dg . corneUII1 of arror. lD plw, COI1IUucUoa, or dolaUoaa of lOr cod.. lYery pmlt 1.... 1ba11 btCDI Invalid
<br />Weal tM tIOrk authorbe4 br .uch Plrlit 11 C*8Ilcec1 within IlllODthI of 1..~, or if 110ft IUtJIorlu4 bJ tba petitt 18
<br />8121peDde4 at ~t4 for a pulOl! of ,11 1OIlt.be aftlr the u. thl lIIOrl 18 ~C8d. onl 90 dar IIt.1ulllD of t.be, ., be
<br />allowed for t.be pmlt wltl! fu cbargl of U5.00. 'lb. 81tBDI101l sblll be reQUUte4 11llfrlUng to tbI Jul14J.ag Officill. An
<br />~roytd ~aD IUIt bllogglO Curing litdl all QUI parloo, or tha project will be amaidlrld 11IaDbed.
<br />WlIIG to OWIIII 'tOOl P1It.UiI to IICOIlD . JOIICB 0' aJOIDCIXDI MY . 1'OOJl 11111 f(II 1'0 YOOlI
<br />PROPD11'. 1P tOO maD to O8!1I1 lllWCIIS, CO.SOL! IflO YOOJI LIKDII IJI JOlla 0'
<br />aJI(IJCIIII!. _ OIDII 12,500 II V1LllI DO lor BID !O RECORD lID f A KOfICl
<br />"'
<br />
<br />
<br />..-------
<br />
<br />StiR or M1~
<br />coom 01 \'~ sO 0
<br />The foregoing ID~t~~t waa acknowledged
<br />before.. thll <:>4){V\ P"7~ 19~ by
<br />
<br />C:;~~ !::~~ 7', "'0~\
<br />who is perlOll.a 1y UOWIl to lie or who has
<br />produced ~~ ,~r ~ u. o~ I\Jc:. t
<br />.s .1d8Dt1 lcatiou and wbo lel/ell Dot
<br />take an oath
<br />
<br />
<br />(Hue.
<br />HOTARY
<br />
<br />KAREN LEGENDRE
<br />MV COMMISSION 1/ CC 222703
<br />. ~:(rIRES: December 12. 1994
<br />>;"",ti lhro NotaIY Public UndelWltt8rs
<br />
<br />
<br />BrAD OF MIDI--, ..
<br />COOllY 01 /~
<br />'lbe foregoing n8t1'l\'l.8Dt wu acknowledgecl
<br />before .8 tl111 /jJ""i/ 1'1 , Ii # by
<br />S/~I.~~ cd - ~~~
<br />who i8 personally knOWD to .. or who bas
<br />produceel
<br />.. i~~~~ d~~ not
<br />tat.~ ~
<br />(Signa ural
<br />
<br />(Hue 'l'Jped, Printed or Stuped)
<br />HO'l'ARY PUBI;ail!~:""~ .OFFlCIAL sEAl--
<br />f~.:E'" .~~ Fred R. Mie!'5ki f')f\1O,7
<br />i*i r~~ My CommiSSion expires 9,""1"
<br />~~. 'Ii eommisslon *CC 320024
<br />~~"'i OF f"'~'~ i
<br />if"IIm"\\\;
<br />
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