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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The"undersigned understands that tbis perJit..ay be subject to "deed restrictions" whieb laY be lOre restrictive tb~Citl -
<br />regulations. fhe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has bired a contractor or contractors to undertake work, tbey .ay be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
<br />cited for a .isdeieanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, if the owner bas hired a contractor or contractors, be is advised to have the contractor(s) sign portions of tbe
<br />"Contractor Sections" of this application for wbicb tbey will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If tbe contractor wisbes you to sign
<br />as contractor that .ay be an indication that be is not properly licensed and is not entitled to perJitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOWner's Protection
<br />Guide" prepared by tbe Florida Departltent of Agriculture and ConsUler Affairs. If the applicant is sOftone other tban the
<br />"owner", I certify tbat I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to coaencl!lent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify tbat all the infor.ation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is bereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a perJit and that all work will be perforied to .eet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies laY apply to the intended wort, and that it is
<br />.y responsibility to identify what actions I lust take to be in co.pliance. Sucb agencies include but are not li.ited to:
<br />· Departltent of EnviroDJental Regulation - Cypress Baybeads, Wetland Areas and BnviroDJentally Sensitive Lands,
<br />Water/Wastewater freatlent
<br />· Soutbwest Florida Water Manageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />· Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />· Departlent of Health & Rebabilitative Services, BnvirODleDtal Health Unit - Wells, Wastewater freatlent, Septic fanks
<br />· US BnviroDlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.", it is understood tbat a drainage plan
<br />addressing a "cOlpensating volUle" will be sub.itted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perJit issuance.
<br />
<br />
<br />S fO YOUR
<br />NOTICE OF
<br />
<br />~-'
<br />
<br />STATE OF FLORIDA , /)
<br />coum OF ;/// <)-{.C)
<br />The foregoing instrument was acknowledged
<br />before me this 8- 3 , 1922' by
<br />
<br />CP<::\rC~\2:"{ \( 6, f,S-
<br />who 1spersonally known to me or who hag
<br />produced t:=:'LtJ- LJ!2.t'i-l-eR L- c .
<br />as identification and who did/did not
<br />tak~ ~n o~th. \\ .
<br />(Si~t~r '=0Lk fL, ~ e:tv f~
<br />..l.- \~ (),A- ,~) ?~~ ~~ .~
<br />(Name, Typed, Printe 0 tamped)
<br />NOTARY PUBLIC
<br />
<br />STATB OF FLORIDA... .
<br />COUNTY OF pi ~");;-~j-C- c'
<br />The foregoing instrument was acknowledged
<br />before me this 'g:,:r , 19~ by
<br />
<br />~~P.tll- t,,/q u <; r
<br />who js perponally known to me or who has
<br />produced ~[)L"l/.pe L,'c'
<br />as identification and who did/did not
<br />ta~,an oath. -" '~,.
<br />~\^~~~.,' -1
<br />(S~gnature). .'
<br />1 I A \nf1, c J.'co, 11 'A~' '"
<br />i '-'J..-"lT . ::; G-7 ' )
<br />(Name Typed, Printe or Stamped)
<br />NOTARY PUBLIC
<br />
<br />NOTARY PUBLIC STATE OF H.G:":'.'r::',
<br />MY COMMISSION EXP JUNE 22"1:';:i~'
<br />BONDED THRU C-.€1iEF;AL WS. lii:D.
<br />
<br />tlOTARY PUBLIC STinE or FL ~:2: D!\
<br />MY CO~li"ISSHYl D~D tliJ!JE ~:L"'99()
<br />BONDED THRIJ CC;[fU'\L W3. i.i1\D.
<br />
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