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<br />CONDITIONS OF PERMIT AVFIDAVIT
<br />, A.,' NOTICB or DERD RBSTftICTIONS . .
<br />!be undenlgu4 un4erataDdl that tbll pemlt lilY be lubject to 'deed restrictions. whleb Ill, be .re reatrlcthe thin City
<br />regulaUoaa. !be UD4erllped uaU1e8 reapoDliblllty for COIPUance with any applicable deed ratrlctlODl.
<br />
<br />n. UNLICENSED CONTRACTORS AND CONTRACTOR aESPONSIBILITIE$
<br />If the QllD8f bu hired a contractor or contractors to undertake work, they II, be required to ~ llceued 1n accorhnce .ith
<br />state anc1local ragulaUOI1I. If tile contractor la not licensed u required by In, both the 0d8t aDd contractor .y be
<br />d ted for . 118delelnOr violation under aute lal. If the owner or intended contractor are uncertdD u to IIblt llceuing
<br />requirBI8Du "J apply for the intended IOrk, they are advised to contact tile City of Zepbyrblll1 Building Departl8nt, (813)
<br />788-6611.
<br />
<br />Furthenore, if the owner bas hired a contractor or contractor., hI is ad~ised to bllve the contractor(l) lign portlOl18 of the
<br />-COlltractor 8ecUlIlII of this applicaUon for which they will be responsible. If JOu, IlS the 0Im8l lip u the contractor,
<br />,OU are iDdlcating that you, rather tbaD the contractor, are rsaponsible for the lIOrt. If the coatr.ctor wiabu JOIl to sign
<br />as cootractor that IiY be an iDlUcatlon that be 18 not properly licensed aDd is not entitled to paltting ptbllegu in the
<br />City of lepbrrbtlll.
<br />
<br />c. TRANSPORTATION IMPACT FEES AND UTILITY CONNSCTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMBHDBD)
<br />1 certlff that I, Ue applicant, ha,e been provided with a cop, of -Florida's Construction LiD LP . beal8lr" Protection
<br />Guidel prepared by the 'lodda Dtpartlent of Agriculture and ConsUler Affairs. If the applicant 18 IQIIOO8 other than the
<br />-owner-, I cartifJ that I bave obtaiDed a copy of the above described 40edeDt and prOliae In good foitb to 4e1ber it to the
<br />-Odlf- prior to ~c_t.
<br />
<br />E. CONTRACTOR I JJ/OWHER' S AFFIDAVIT
<br />I certify that 111 tbe lnfoIlitlon in thil application il Iccurate and that all work will be done in CDlplilDCI with all
<br />applicable 1118 regul.t1ng CODItructlon, lOI1ing, and land dev81o~ent.
<br />
<br />Application 1. herabp lade to obtain a ptnlit to do vork and ill8tallatlon as 1l1dicatsd. I cerUfy that DO IOrt or
<br />inatallatloa has ~ prior to iuuance of a perait and that all work ,Ill be perforJ8d to _t stlD4aro of alllavs
<br />regulating COIlIU\lCUoa, eltr co4ea, loning r~lations, and land devaloptent regulations In ~e jllda4ictlDll. 1 also
<br />tertifr that I undtrataDd that the regulaUOtlI of other goteruental agencJ.sa ur apply to the iAteDdtd lOCk, IDIS that it 1&
<br />If rUpoDIlblUtf to idl!lltlfJ what actions 1 aust take to be in COIPliance. Such agenda include but are DOt lWte4 to:
<br />I DepartlBnt of Indrouental RtQ'Ulltion - Cyprus Bayhllda, Wetland ArellS and BnvirOlllll1ltallr SeDBlt1ve LaA4I,
<br />WatH /Vute-Iter TreatleDt
<br />. Soutblelt Florida Vater IfWCI.ut Dl,trict - IIells, Cypfas Baybead., Watland Area., Altlring latercounea
<br />t ArIY COJPI of ~ .. _.U., Docks, lavigable "atenra,s
<br />. De~t of Bufth .'-Rellabllltathe Senlces~ ,JDvironllntal Health unit - VeUI, wutnater rreataent, Baptic laW
<br />t US 1Il1'~~tal ProtectlOll ~CJ - lsbutOl abatuent
<br />I a1&o certify tbat, If fill llterlal il to be l1Ied in Flood Zone 'A' or 'lrl,etc. -, it I. W1d8r8tood that a dra_ plan
<br />iddreuillg I .ClWplDNUng vol..- will be subtitted which i. prepared by II professional engineer ng18tered III tbI State of
<br />Florida prior to perldt 188uaace.
<br />
<br />
<br />STIR OF FLORIDA
<br />comm 0' s:7t 0((' .t'()A
<br />The foregoing instruaent was acknowledged
<br />before me this (.~ f.,.,}{)V , 19..iliL- by
<br />~ \ti1LKF .,
<br />wbo 1s personally known to .. or wbo baa
<br />produced -t="b. ~ \'0 f ~ Ll(' ~ ~
<br />as identification and who did/did Dot
<br />~~~#p~g L?~'
<br />1"ifgnature) ~
<br />I-J~ ~()f'-fIA~ ~
<br />(Hue Typed, Printed ~ Stuped)
<br />HO'I'OY PUBLIC
<br />
<br />StAfI or MIDI
<br />coom or ~ F LQ){U.. ()=>r
<br />The foreqoing inatrument val acknowledged
<br />before a8 this m ,.\'ml f 19~ by
<br />
<br />-.. 9(~ VAUS~
<br />who is personally known to lie or who has
<br />produced -fL.... ~-l)~ I \U~L
<br />88 identification ad who JUMdid not
<br />tay~ oa~.~
<br />~~llP ~~ t?J\
<br />(Si~tur.) "'1"1
<br />.J-j{lJCj} ~l)<t- '~~~~
<br />(8..e, Typed, Print 0 Stamped)
<br />NOTARY PUBLIC
<br />NOTM?Y Pl'el T
<br />',1Y 1-,_,- J..,"C $T,ir- OF'
<br />Ij"\ ';J;'''''_~S~ICJtJ E'~;> \'. F:ORIDA
<br />U,/Llil I,":')" r'-', dut,E ?' "',"5
<br />. - 1l1H.) tIt \.It~'v ..... -I.., .:';,'j
<br />-1,,-,,,' i.., lNS~ !./'ID.'
<br />
<br />. :::'UiieL) L.au I
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