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<br />~.__.-._. OCT-13-'94 THU lCl: 12 1D:
<br />
<br />TEL NO:
<br />
<br />l:f318. P02
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<br />.1
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<br />
<br />CONDITIONS OF paRMIT AFFIDAVIT
<br />A. Jf02'I~ RB8TRICTIOg
<br />11II ~ ~t W. PIII1t ., be UjlCt to 'lJIed l'tItrJctiOll' IMcII .., .. ... rtltdctb. tMa elt,
<br />'egaJ.u.. .....-u........ rt8pODllhiUt, for CCIIIpU.. 11th III, 1JIp11ClbJ. W lII~. .
<br />a. . UlfLI 8 CONTRACTORS AND COlf'J'RAC'l'OR SIBILI'"
<br />If tile MIl .. Ill. -tractoc or COItrietot. to UDdertdi IfOrkt Ue, .., INI nQulnd to 11.... II ....... ..iei
<br />ltate .. JocI1 nguJ.tJOIII. If UIe contrlCtor J, IlOt J1C81l1Id u ,.uld br 1., !Iou. tile Mer .. CIJItQctor ., ..
<br />cUed for .11~.lIaor ,lol.UCla under .tete I.. It the GIIDIl' or IlteDded atrector 111 UICIrtIIa u to .t llCIIIJqg
<br />npJ~tI .., Ippl, for tJIe JatacJed IOrl, tbeJ are idYilld to caatact till cn, of IIpIIJrWle 1II1tJ" ......., (IUJ
<br />7"'''11 .
<br />
<br />JUrta'lon, if till .. ... .itld . COItractor or eontnctor., lie JIIlIv!ttd to 11m till ClOItnctOr(I) lip __ of ~
<br />'COatrlCtot .....~ of WI 1pp11~Ufll for Irhiell ber uUlIe r.,.lble. If JCIU, II tJIt .. 1111 . till ClOItnctOr,
<br />JGU m iIIlcaUag tt.lt IGO, r.tIIer tJIaD tb8 coatrector, "' rupouJbl. for tile IOtt. If * -tnctor ... JGI to 1111
<br />II alItnctor ~t ., lie ID IIdJcaUOIl tblt lie ia not pl'OfUl, llC1D1td ucl11DDt .UUII1 to JImIttllt Jd", Ja *
<br />at, of ....Ullt. _.
<br />C. TRAN8PORTA'1'IOIf IMPACT FEBS AND UTILITY COIfNBCTION J'BBJ
<br />D. CQN8T~ION LID LAW (CHAPTBR 713, FLORIDA 8TA'1'UTBS, AS AIIIIIDBD)
<br />1 CUUIJ tlaIt I; till appllCIDt, ... - pm!c1tc! ,itb I CClpJ of ',lorld1'. CGIIItructJCII W. ... . ~'. PlOt....
<br />GuJdtl p~ " tM Iloddl DlplrUat of Agriculture aad COnMer Mfdn. If tbI illPUeat It ..... otIIIr ~ tile
<br />'...', I cert1tr *t ll1att abtlJDeG . cop, of t.be ... _fiNd -.at ., pr._ iI ... fd~ to ..11_ it to till
<br />'0IIIIt1 prior to tlGWllIHIht.
<br />
<br />B. ~Bt8/OWNBR'S AFP'IDtaVIT
<br />I CItt1rr tllat WoniuOft la W. ."lIeat Oft i. aecur.ta ad tblt .11 wrk .ill be .. II ..,U.. will III
<br />Ippllabll 1_ qp1atlDg QIIItnJcUoo, DJog, 11I4 lead .'I1GpIIDt.
<br />1pp11CIUaD it ...,.. to obtain. perIn to do IOrl _ lnaWI.UOIl u IDdieated. I ClrUfr tMt.. 110&'1.01:
<br />iDlU1lItt. .. .ooIIIDCIlJ prior to iauuce of I peaJt IDd tbat 811 lOll will be puf.. to .. It~" of III ..
<br />reguJlt1Dg COIItructIOll, cn, cad., lOlling regullUOII, aDd 111II1 d.rtlas-at rep1aUOIII II till ,arJ.acu.. I 1110
<br />certifr tMt I UDdInta4 tltIt tbe reguJIUClftI of otbtr goy....tt1 1tW!C1. IIJ appl, to tJIe lDtIIIII -a, .. tMt it II
<br />II rtIPGIIIlbllltr to l"Ufr .t acU. I IUIt tab to be ill _l1uce, hdI ageaclu JlICllll1l .t In DOt ltlltld to:
<br />· ~ of 1DfI.........l bqyllUon - Cypr... Barbudl, VltllDl1k... Illlllori-.t,U, ....U" '-*,
<br />IfIter/IUtlllter _tat
<br />· JoatMIt floddIllter ....rr't DJ.trlct . WeU., CJprea ..,..., ItUIDlJ 1ruI, Iller'" latIrceanM
<br />· b QIcJI of IlLtiiii · '-UI, DocU, "'lgable Wlten.,.
<br />· .....t Of ~tiT""UltaU" lint.. IDrJI'OI1II8IlQ,l 8ellt,h Uait . IfeUt, "_tit lrII_t, ItpUc flab
<br />t US ~ ~III ~ - J8J1eetoa lbau.t
<br />11110 ..ur,u.t, If rlil.tlrlal J. to be_ ill 'laad lODe 'I' or '1,.te.l, It it undIntood tat . ...... ,1.
<br />.... · .~ tOJ.' "jJJ be IUlJljttld Q1c111, PfIIII'Id bJ I ,rof.JIII! ... ",ilta II tit.tltI of
<br />Plod" ptlor to JItIIt I.uuet.
<br />J l*t1t ...... tbIIl .. mutruld to . . U... to proceed ,Jtl tM IIOrk IlIId DOt U IUtIIodtf to tillite. OIIGIIl1ter, or
<br />..t ulde .., pnr1llau of tJIe tedlDJcaJ c:ade8, nor 11II11 illUlDCl of . pera1t prmat tbllldWlt OfflOlll ,. tlllnlftlr
<br />r.rJag I CIOrrICtioD of errore II pl., catructJllII, or flolltlOlll of an, _. ..., JUIIt ...... MIll .. bQ1H
<br />uaJIN * .l..b.. br .. peqit II "'aclll .f~l. .11101I* of J...,Mct, or If 1Dr11Uttorflll" tlllpalt 11
<br />........ or ~ for . I*lod of Iii -tbI .fttr Ue till tJIe ror1 II en la. GII"'" _.. of till, III III
<br />aU_ for * palt .SUI fll cIIaqe of'15.00. rile a_fOIl .ull be ~ Ja II'ltlag to tIIIluua.. Off1c1l1, ..
<br />...111 iIIpecUoI_t be JoggI4 during ..et. .11 _tit period, or tIaI projltt .111 be a:u.t.... _--....
<br />.... to rAIII: .. Dl_ to IIDID I alCl. or ~ 11I1 ...r II lOUR PIlIl8 IIICI a ...... !O IIUI
<br />...... JP III ... fO Clrm fllUCllG, COI8UI.t Ifl18 _ .... (III &mIIIIr ... ...... DlCl or
<br />~. .. 11III P,. U 'AWl DO 101' _ to RIaID lID I'08f I 'ala or ~'.
<br />
<br />~~~ ~#!~~
<br />
<br />-,.~
<br />CDIIR or
<br />Tbe fongoag ~t .... ilcmowledged
<br />hefon _ tb1. /0 /17 _, 19 q(f by .
<br />I --+-
<br />A 1- O,J R..f{ er-J
<br />who 1. 1 J bowa to _ or who baa
<br />prodU _
<br />u Id-.Ul!Citroa 8Dd who did/did Dot
<br />tate ... oatil.
<br />
<br />BUll or ~
<br />CXIUJft or ~~A)
<br />'I'M foregoilag 1Datff:{!l: _ _~
<br />before - thi. 0 7 , 11 9V by
<br />- ~J.:~~w. flu
<br />:O:=li1catioD aad vIIo tid/ciid DOt
<br />take Oftth.
<br />
<br />
<br />
<br />a
<br />s May 16, 1995
<br />CC110274
<br />
<br />
<br />JAMES A. STONE
<br />te of Florida
<br />m. oxpires May 16, 1995 - .
<br />CC110274
<br />
<br />,JIY
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