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<br />--. - .~V-30-'94 WED 14=00 ID:
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<br />11054 P02
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<br />CONDITIONS 01' PBRMIT AFFlDAVl:~
<br />A.. ~ OF DBBD RB8TR:tCTXON8
<br />IIIe 1IIIiUiI. -.ntIIIGI tall tll. penlt Iif be IUbJeet to 'deed rutrlc:t.fOftlIl .1e11 _, H .. rMtdutl" tbu City
<br />rllll1ItJCIII, ftIt ........... .... ~lbJlJt, for OOIpUance .ltJs IIJ IlppUClbI. 4IIlI rutrlct1C1D1.
<br />
<br />8.. :LCBlfS CONTRACTORS AJfD CONTRA S
<br />If tbI 0WMr 1dn4 . caatnc:tDr or coauacton to ~." ., repl to .. 1lCMM4 11 aceort-. IIltla
<br />.tata IDd local .IUaaa. If tile COIltrlCtor 11 DOt Ucmaec1 .. reQlllncl by In, botJa tile __ _ u.tnctor IIQ be
<br />c1tlll for . 111d"-~t ,loJltlOU _r ltete t... If till Ullll8f or lateAde4 coatrlctor an UDaartUI u to ..t llCIIIII....
<br />tllJlllr_ta., Ippl, for ue InteDdelJ 1101., UaIr art lIttiRIJ tD CODud the CU, of lIpb,ntllllllll.... DlplrtMal, (813)
<br />711..111. .
<br />
<br />rutbulDre, tr tM -- ... Url4 I c:GIltractar or conttlcton, be II 1IIY11Id ta Uft tJae CIIItrIetor(.) Iloa JQrt:.ku of the
<br />-Coatr.. a.cu-. of W. ..,Uc:aU.. for nidi tar ,,!II be rllPCllllbll. If raa. .. tile Mer .lfIII . till alIIttlctor,
<br />roo In IIIIlfltlDg tW: JOG, r.t.IIu tIIu tbljeoDulctor, are rupouJble for tJae IOrl. If u.e cootrlCtor .111III JOII to .Ip
<br />.. ClIIBtnct.Dr did .., H II b4tClU. tllat 11I11 DOt prapulf llCltlll14l1Dll II .t IIlUUIl1 to ....tUlg pd.11IIIIla ~
<br />City of .......111.
<br />
<br />C. l'RAII8P01rJ'A'l"IOIf IMPACT nBB .AND UTIL:LTY CO~BctIOJf .PDB
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<br />D. C~TRUCTIOII LI.D LAW (CHAPTER 713, FLORIDA STA'l"UTBS, AS AlllUlDIm)
<br />I cartJfJ I, .. ",UCIIlt, .It beta profi.ea witll . COpy Df -'lorlda'. CaIIttmcU.. Lten l01I . a.a..I. Pnbct1CJIJ
<br />Oalae- PlII*1I br till rlodaa Dlpubeat of Ivdllll1Lve Pel ~r Affdre. If tlIt IllPUcat .. ...... otlllr tIIta tilt
<br />-..,., J c.rtJfJ tIIIt J ... Ilbta.... I COfI of tJat ... deecdW aucu.eat _ pmaIA ill .. ftJ~ to iliUm it to till
<br />..... lid. to ^ I - -to
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<br />1:., ~t8 AFFIDAVIT
<br />I CIrtt W. applleatlClll II .ccmt. IJId that III .. ,ill III ... ID ....1... .1~ dl
<br />lpplJePle .. npJ.tlnt CDIIUlICU., 1CIdDg, IIIlI JIIIl1 dmI.....t.
<br />
<br />
<br />IPiUClUIID U ........ .... to obtllD . peralt to do work .... lnatall.t1oa It JDdlatlll. I oertU, Uat DO IOrl GC
<br />_WI.tS.. ill ol:DUI a.t pdOl to 1II1IIDCI of I JIIIIlt IDll that IU.. .UI III IIl'toneG to ..t IlIII1IdI of III 1_
<br />regulaUag cautncU., City COI1eI, .wag nqulatiou, am11_ t1enl~t ngaI.U..- 10 tile jurll41c:U.. I 1110
<br />c:erUfl ttat J UftdItttlld tbat tile tI981ltiotd of other gonn.eatal '9l!Idn .., ."Ir to tIae 1It1ad11 ..., 11I1 t.IIIt It I.
<br />IIJ retpOllli.Ulty to lc1eaUfJ idiot ec:UOQ I Qtt teQ to be 11 COIIPllenc:e. Bucb IgelClu IIlCl.. ..t III aat llalttc1 to:
<br />· lJeJIrt.at of Inl~tal _IIUIIl - Cypreea ..,..,., _tl_ Ireta Pet "',lroumtIUr '-ftln ....,
<br />later/IM__ttr frutlleDt
<br />· Sol' D f - "'U., c"r. 1Ir'ad', V.t1aAd lnal, IlteriDg IllterCDUrlll
<br />t If DDe , ..!gebl, llatenrera
<br />· IIItablUtltJft lenl Ia.
<br />· tUl ~t
<br />1 . ID , . II I. to lie IIeG fa 11004 ICIDI -I- or WI,lte. -, It J. ~ta .....t I drl"" ,lID
<br />...... · .f....1Itlag 1Dl_. will III --tte4 IIblci I, prepmd by . profeulouJ tagw. reg1ttenil .. till 'tlt. of
<br />.lorlll frlor to palt I....ce. .
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<br />I penit ... "1 ... 0DIIItnec1 to be . UCIIIH to procet4 II~ tile lOt. ana DOt II lutIIodtr to Ylolltt, CIICIll1t1r, or
<br />~t "I" .. pml.IOII of tM t_leal coc1l1, IIOl' .ball bnaace of I penJt prlftDt tIae 1d14llg Dfflc1lJ Ix. tMnIftar
<br />rlfJlJrJag I cornctlCII Dt urora 1Q pl., CIIIItr1IctiCII, or YlollUOIII of 111 co4l. hIq....t 11IIIIl1111a11 .... 1.IUlI
<br />11I111I UIe 1IOr1l ntlmfle4 bJ MdI penlt I. ~ -ltIaU .i. _till of 111IIIII01, or If ..II IUtIIodlllt ~ UII peait b
<br />IUpIDdId or PlfloG of IU atllllftlr tbe t. the 1IJl1I JI . 0 tar utllllGl of lUt, ., .be
<br />11I0IIId for It vltJ1 f. dIarp of '15.00. !be ht8ntiOll 8ball tel Ja III to tilt IuUctllg Official. In
<br />appronc1 t lagged t1udng IiIdllil _tla period, pro' t .111 be ~J 11>>*-1.
<br />_IIG 1m m ~ J IOI'ICI 0' II YOOI PIIIIG ilia IOII1PUNm 10 YOOR
<br />, lIlIUcIllQ; CDlULf II" 1'mIIIIt .... ......1'OIII1IJfI0 Of
<br />· ... .2,500. 00 Q IIItJ ro 'IlOIlO or '.
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<br />IDJI ~---tr&ft or I'IWIl 0
<br />\, /lee..NAAJ~o aomor IItzK/V;1ND
<br />The foregoiag .t.D.~t ... eebowlecJaed 'file fOl'll901Dg iDa~t w.. .~~eclg8d
<br />IMIfore - tbu I~ / SI , 19-fr' by, before _ tllt. I.:J. / / , 19 b~
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<br />" .. .1.' tJ~ own ,~ or who Jia. who i. ~"11~ no.. t:o ~ or wJao ..
<br />produ(!fld. pr04ue _
<br />as idea'ti ca 41 414 not .. identifiea OIl IIDd 4 !lOt
<br />-take _ 08 tate an oetb
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<br />NO'l'ARY PUBLIC
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