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<br />-..,_._,-,~-,' OCT-13-'94 THU 10: 12 ID:
<br />
<br />TEL ,jfJ:
<br />
<br />1:*318 P02
<br />
<br />CONDITIONS OP PERMIT AFFIDAVIT
<br />A. .-ca 0. DBBD RBSTRICTIOg
<br />rill ......... tIIIt W. Plmt ., bi Mim to 'w l1ItttcU.' Ibfdl.., be.. rtltrJcU" tMII eltr '
<br />r.ItI... 1Ilt...-u...... l'88paIWbUit, fOt CCIlIpUace 'U!!., 1pp1lClbl. l1IIc1 tII~. '
<br />8. DlfLI 8 CO RAC'l'ORS AND COHTRAC
<br />If . --.. td a -tractor or CClItractor. to undutdi IIOd, tie, .., nouJ to __ II ........ viti
<br />.tate .. JKIl _IIUau. If th coatrlc:tor J. aot 11*811I . tlflJirld ~ 18, both tIat .-r lad ___ ., bI
<br />cited for · .bdJlIIlIDr Jlol.tioa under .tate I.. If tile 0ID1f or JnteDde4 _tractor 111 UDCIttIJD u to .t UCIIIIIIg
<br />r.~tI.., Ippl, for tJae Jntlnc1ec1lOrk, the, are Idvilld to CCIIStlct tb8 CUr of IIphrrW1I klJ....~, C'UJ
<br />788-6611.
<br />
<br />
<br />JUrtlllrlOrl, if tIaI_ .. bind. COfttractol or contnctor., be II idvJlId to 11m * ClGItrIctOr(.) lip ~ of *
<br />'CaatrlCtor IIIctJ..~ of W. IppUetUCIl for nidi tIaeJ ,Ill lie r..,.Dle. If rou, . tile .. 1111I u U. a&rIctIr,
<br />IOU In lII1eaUag u.tt JII, retlllr tJwa tile eaatractor, are rupouDle for tile 1fOd. If tile CllDtnctGr ..... JOI to 11t1
<br />ill c:GDtnctor tMt ., lie II la4JcatlOll tblt be 11 DOt prOplrl, llClUtd aa4 11 DOt .UUIII to JItIIttlDg Jdtlltlll Ja .
<br />Clt, of 1IpIaJU1111., I _,
<br />
<br />C. ~ IMPACT FI18 AND l11'JLIn CONNBCTION ,..
<br />
<br />D. COHS'1'RUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTa, AS AlllllDBD)
<br />t Clrttfy talt I, tJIe IppUClDt, ..lieu pmic1td ,JtJt I COpJ Df ',lorlda', c.trucUCII ... .... . ~"I. ProtIcUolt
<br />GuicJt' pnpIttl1 br tU florldl DlpartMt of Agriculture u4 C-. Alfalrl. If till appUcut la ... otIIIr tMI tile
<br />'CMIIl", I cutltr tllat Illite obtained . COPJ of tJIe 11Io.. ducdMd __t 8IId prGIlu hi ... fd~ to dIIi_ it to tJII
<br />'011III" prior to ~Dt.
<br />
<br />B. ~"8/OWN8R'8 AFFIDAVIT
<br />I ctrUr, tllat U. lDfGaiiUoll fa W. application i. accurate ad tblt all .or. will bI ... 11 ClOIflllDct .I~ 111
<br />IpplJClIbl. 1_ nplttlllg c:GIItrKUoo, JODiDg, iD4 IIDd .'l1ll(l1e8t.
<br />1pp1lcaUclD 1. .., IIIJe to obtain . perlU to do IOrk IIId tllltallaUOI II lDdJeatld. I cut1fr tMt 10 ... OC
<br />iDltlllaU. laM oMlIJlI04 prlor to JIIIIIDCe of I peoJt IIId tbit aU lOll wW .. perfOtllll to...... of ,11 ..
<br />regulltiag COIIItncUoa, Cltr cadeI, lOlIing regullUona, ., laact dlvelos-at ngulIU. 1a ~ JatltClct*. I alto
<br />certifr tMt I 1III1mt1D4 thlt tk reguJIUCIIlS of otJIer fOYlrMtDtIJ IIIDCI.. 1I11pp1r to tile tatIIII4 -a, ... tMt it 1,
<br />Il r..,.lblliq to "Ufr IhIt ICUODI I _t tOe to III la CGlp11... 81Q lVeacl. IDC1. IIat In DOt 111ltlt tI:
<br />· ~ of IDfl~1 _taUon - Cyprtll ...., Vlt11Dll &r... IIIIlI ~tI11r IIDIJU" ...,
<br />Mlter/IUtlllter 'natat
<br />· IoatMIt rlorJdl Miter IIIIIINIDt DJ.trlct . 18U., Cypr... ..,...., "'tlllld 1ruI, l1terllg ..___
<br />· of . ...It, Docb, 1I'lgable ..ten.,.
<br />t. 01 'IMabUltaU" Blnl_ btJr..h1leilth Drlit . 1feUI, IlutMtIt rr._t, ItpUc fIIb
<br />· VI ~ Will -.n - Jlbatol .~t I
<br />11110 .u ___no t, 1 fill _wid is to be _ ill rlClClcl .. '.' or -I,.te.', It i. IIIII1Intood tat . .... ,Iu
<br />addrUI1Ig · .,.....UIg tOI.' will be auIlI1tt.. .bicb I. pt_. by a profudDlll1IDgI_ ngiltlnl1l1 tIIIltItt of
<br />Ploddl prior to pIrIlt ......
<br />I pen!t ...... ..II lie ..trued to bI . UCIDIe to proceed ,I~ tile IIOrt ... lOt U IUtIIorUr to doltte. CIIOIll1ter, or
<br />lit aide ., ptOflllolll of tile tlcbDtCll c:odea, IIOr shlU illUlDCe of . perl1t prlYlllt * 11II_ OfflOlll ,. Ulnlftlt
<br />r.d., , cornctloD of errore 1a plaa, ..traction, or ,lohtiou of an, _. .., _t ...... '1M11 ... JaqJH
<br />.... tM .ilUtlR'''' br .. petlit 11 "<<)IIIWlICId Idtbill III IOD* of i.~, or If .l _11II., u.pertn !I
<br />.... or ..... for . period Of 111IJDtI .lttr t.'- U. tM .r. II .... r.....,..." u., ., ..
<br />aU" for be palt .lth f. dIaqe of ,15.00. 'be IItIIIIloa iUl1 be ~ illlrltllg to tIaIldWlg Oft1cll1. III
<br />IppfOYII1 iDIpectloD _t be 1_ 4urlng eacb .11 ath perJ04, or till project 1111 be CODIi.... ....
<br />"'1. 10 MIl: .. fill. to II.'ORD A JOI'IeI or aJIIIICIIIr III IlSULr II tool Plro; tIKI .. DID_f' 10 1M
<br />PIIIIIJ. 1111IO UIIID to <<11m 'IIIIICIIG, aJIBUL' ifIll fOUl ..... (III &mIIIr ... QOIDIJ8 .. IIICI or
<br />~. - 1IDII1l,. U 'UUlIX) lOr IUD to RICCIID UD rosr I -alCl or ~1Bf'.
<br />
<br />~
<br />
<br />~
<br />
<br />mil or RGIIDI~
<br />aim or 7lS(!o
<br />'be fongo1Jag 1IIatl'ua8Dt .... acknowledged
<br />befon _ tbl. ~ c;l7_, 19~ b, '
<br />MI1~Ai~IlA'Il"/'--"
<br />~ 11, bGIID to _ or who baa
<br />a. id_ullCitrOD IDCI did/did Dot
<br />take oath.
<br />
<br />
<br />JAMES A. STONE
<br />
<br />BUR or MIDI /.7
<br />CDIIIY or r /9S(J 0
<br />'lb. foreo-oiag 1a.tl'UMDt ... acllDowledged
<br />before - tbil t!l:.t- ~7 , 11 9Y" by
<br />~ ~NP~~/ll"""'-'
<br />.110 .. lly bowD to _ or 1dIo ....
<br />produced
<br />.. ldeDtil1c.tioa aad
<br />un 04th.
<br />(8 ' tare) AMES A. STONE
<br />, Not~cy Pllhli~ ~t~to nf f=lorida
<br />(N_ Typed, PrlQted O~~~ires May 16, 1995
<br />JfO'1'ARY PU8~lC CC'110274
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<br />. TJped, Pr
<br />JIOtAIY ",LIC
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