|
<br />. .. SEP-22-'94 THU 08:51 ID:
<br />
<br />TEL NO:
<br />
<br />~269 P02
<br />
<br />,-
<br />
<br />CONDITIONS OF PBRMIT AFFIDAVIT
<br />A. NO'lICB OP DBID RB8TRICTIOHI .
<br />!be un&nlgolG IIII1mtla tllat W. palt IIJ be .abject to -W restricti0D8- Ulc:b iii' be lOtI ratrlcU9I tIIIIl Cit,
<br />t8g\Jlatlalll. 1M UDCJmlpea UI_ rupoaalblllt, for CIlIplllDC1 with 10' applicabll W r.b'ic:tiGIII.
<br />
<br />B. UlfLICKNSBD CONTRACTORS ANI,) CONTRAC'J'OR RBSpOlfSI8ILITIBS
<br />If the .er .... bind a CClIItractor or contractors to unc1ertUt lOr., the, M' be rtQU1rec1 to INIllC8ll88l! la accodllce with
<br />,tate 1IlI11oc:a1 ngulatilJlll. If the contractor 11 DOt l1cenaeG u rlQllirecJ br In, hotb t.be ... _ CIlIIItrKtar .f ...
<br />cited for a Ilea.lDOr violation under .tatl 1.1. If the owner or Intended caatractor are 1IIlCUta1D . to _t UCIDIInq
<br />tlql1lr_u ., .,,1, for the Inten4ed .ort, they are I4d&el1 to CUDtaCt the Cltl of Ztpllrrblll. IuildIDg DlplrUat, (813)
<br />788..&611.
<br />
<br />Fvttbenon, If tbe ower baa hired a contractor or ccmtrlctorl, he Is 14,1814 to haye the COItnctor(l) llga portloDa of U.I
<br />-CODtrlCtor 8eet1.. of WI IppllcaUllO for 1b1m ther ,JlllIe rllpOOlible. If fOU, ill tile ... UID II tIMI c.uactor,
<br />IOU are lDlJlcatlDg tllat JOU, rlther thaD tbe contractor, are r88ponaible for tJae lOr.. If tile coatrlCtor IlIIleI JOU to llga
<br />.. CGIltnctor thlt ., be an lJiIlcatlon tllat he II DOt propetlr Utaec1 and II DOt 8Iltlt184 to pealttleg ,ridlegu In tb.
<br />Clt, of 1e(Jllrdd11l.
<br />
<br />c. '1'RAHSPORTATlON .:.IMPACT FEES AND UTILITY COH!fBCTION FBSI
<br />
<br />"~~'Ji" :---~~ . . "''l.':,' .
<br />
<br />D. COHSTRliaIOH LID LAW (CHAPTJl:R 713, FLORIDA STATUTES, AS'AMBNDBD)
<br />1 cert1fJ that I, tie Ippllcut, "'98 bleD provided litb a cop, of .Florida'. COnItructiOll LIID ~ - ~I. ProtBC:tl~
<br />Guide- preparec1 br the 'lOrll1all8pl1'tlent,o,r ,AgriCUlture 8D4 CousI1lllr Iffllrl. If tlJIlfPll~~'l).~'OtIIer than the
<br />-oar-, I ClttlfJ that llla":i'-tIit\~ A: ~;C't~f the above t1ucribetl cloa1IeDt anc1 ptOIin tD 'iOIiG' "IUt to delbu It to the
<br />-mmer' prior to CXl.lnc_t.,,,~:.. 0;,...;. .... :;. ' ,......
<br />i{(.:.Io:' .i;''''''/C 4,~.~ . "~f ~~11'!:"~' .:' :', :}_.~\~~ ,..v.;,' >'~~. .,;. ~:';r:'~ .'
<br />E. COlft'RActOR's~~'"..nDAvIT"",~P:~"':~~' ,'i,': .: ~~..
<br />I cerUf, tllat ,II ~ Womatloo lD thl8 applicatlOll II accurate an4 that all lod will be ....h Clllpl...ltb III
<br />appliabl. 1_ rega1ltiDg catruCtilll, lUg, _ llIl4 l1et.~t. ,~ ./1 .. ,~ , " ."
<br />
<br />ApplicaUon Ja bet. .. to obtain a pefI1t to 40 wort and InsuUat101l 18 iJl4icated. I cerUfr .....t 110 .r1 or
<br />lutallaUoa .... -=--Bc1 prior to l..I1IDCI of . penit and tJaat all wor1 ,ill be perforlec1 to .. ......... of 111 1_
<br />regulat1q COIIItrueUOIl, Clt, c:oc1ea, lOfting regu1atlOlll, and IID4 c1mI.-t regulaUOIII la tJaI jadlllctlcla. 1 1110
<br />clrUf, that I ua4entlD4 tJlat tile regullUCIlI of other 9O'f8llEJtaI ageDclu ., apply to till 1ntea&te4 110I'1, 11I4 tut it il
<br />If rea_abllitJ to ideDUf, ..t act1Ol11 I 1U8t take to be in COIPl1anC8. Such 19_1. Incl_ bat In DOt l111Uc1 to:
<br />t DeHrtleat of IDYlrCllllllltal Reaulatlon - Cyprlll Bapeads, Met18Dd lreu anc11D,irollllllU1l, _iU" J.IaU,
<br />Viw/Wlltalter !r..tIeIt
<br />t SOUtMIt Floria later ~t Di.trict . Ve11., Cypnu laybeads, Metland Ireu, IlteriDv lltercour.
<br />t 1m em. of IIIIIDten - a..u., Docb, 1i,lgable 1IitetRrl ,
<br />t ~t or INltll i .....l.l~ti" .mitla, IIlfJrCllll8ltal Health IJD.it . !fells, .._tar _t.lt, SetUc I_
<br />t DB 1DIirW'ta1 ProtIctlOP IIIOCJ . Isbutoe abatMllt .
<br />I alaa eertlfr tllat, If rill .brlal II to be _ iD ,lood loDe 'I- or -l,.tc.', It il UDderIt004 tUt a dta!Dlge plan
<br />aMr_lDI I -..,..tIDg vol.1 1111 be ._ittea which is ptepalec1 bJ . prof_laaal ....r regilterec1 U till ltata of
<br />flaclda ptlot to pmlt llIlIIIlCe.
<br />
<br />I peott I.. allall III COJIItrue4 to be . license to proceec1litb the IlOr. 8DclllOt 18 autbodtr to dalete, CIDCIlalter, or
<br />&fit .ala. IUlf prowl.IOIII uf the tecbntcal code., not 8ha11 ill\llDCl of a pem1t ,tlYlllt the Bulldlag Official fIw tberufter
<br />tlCJIlirlDg I corrlCtiOll of Irron In pl., COd8mcUcm, or YlolaU0D8 of IDf coc1e. IYerJ palt 1uaIl1.1MI1 ... 1DYaIld
<br />unleal * _II IIIthorlllll by _ petitt 11.~e4 "itblll Iii IODtbI of IBIlIIDCe, or If _1 autIIor1ll4 br till pemlt 18
<br />IDIpI!IIdeI or IbadGIIIll for a perl04 of ail IOIItJaa after the U. tbe IIOrt II c_eace4. CB 90 dIr uteM!IIl of u., -, III
<br />aU.1Id fOt the perIIt vltJI fll cbarge of '15.00. !he utalOll IIIall be rlQUllte4 la uitlag to tile IuiWat Official. In
<br />appmecJ laIptcUlIJ m be 101914 4uring IIcb IlIlOIItb period, or the project .11111I ...illenll -lIlooetI.
<br />MI. 10 CIIII: mil '1[_ ro IICOID I JOlla or ~ 11I1 IlSULf 111101II Plfill IIICI fill lIIIIJU.-r8 to 1001
<br />PlOP1m'. U 1fIJ JIIIID 10 O8Im FWlCIIG, mlSUL' IUD YOIJJI UIDIR OR 11 UICIIIIY .. ..ur: .. JOlla OF
<br />CCHIIIICIIIDI. .. UI1I8 .2,500 II YILUI DO lOr IBID !O IICOID lID POSt 1 -1fOf1 ..
<br />!
<br />
<br />
<br />nlu or MIDI
<br />CCIIIt or ~o u. ~ 6t
<br />Tbe for. DV iU8t:nJlleDt WI8 aclulowledged
<br />before.. tbi. ;l.,:J... fb~T, 19..2!L by
<br />~ 1~t'1 ~~-rr~
<br />who i. perIIODally bmm to _ or who has
<br />produced
<br />as tlficatlan and who did/did Dot
<br />tae
<br />
<br />81111 or MIDI .
<br />coom or J..I. { lis .R.o (~,/e b i-I c
<br />.Tbe foregoing iD.tl:'1m8n~, ... .~la4g..s
<br />before ., tbll s,n- "Z;L"J.f.' 19 if by
<br />~ I.,
<br />. 0 '\ l roe PI .r-se A-f'~ '
<br />wbo i8 persODally ImOD to or woo haa
<br />produced .
<br />as identification aDd who d1d/41d Dot
<br />ta
<br />
<br />
<br />
<br />.
<br />"t;
<br />
<br />(Signa ur.) ,",'
<br />. Nof8ry Mllt, St.te of F-iOltr.'"
<br />~~'aD6
<br />(H.., fJped, Pr1Dt~ , )
<br />NOTARY PUBLIC }
<br />
<br />:1~,,;;~~,~: ~il,k,.,'R',,,.
<br />
<br />My~~ 27. .~ :...., 0' ''';';~a
<br />eo.n. No. CC 24839.1" , 'Y-"
<br />
<br />. "f .."
<br />
<br />NQtwy Public:,. S'ate' ~ Florid.
<br />If,y c:amm. expire. Dee:. 27
<br />(Haas Typed, Print
<br />IIOTARY~IC
<br />, ~ltEN ~.-~
<br />~,. ~~II~,W,,' '~j;1.foricf.," '. "#1',
<br />, ~~>>:'" I
<br />. ....,.cc ;t.. "J"4.
<br />, ,.i~.. 1fB39.
<br />
<br />~."''''nl
<br />
|