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CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Ibe undersigned understands tbat tbis penit laY be subject to Ideed restrictions I wbieb laY be lOre restrictive than City regulations. !be undersigned assU1e8 responsibility for cmpliance witb any applicable deed restrictions. ' B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If tbe OIlIer bas bired a contractor or contractors to undertake IIOrt, tbey laY be required to be licensed in accordance witb state and local regulations. If tbe contractor is not licensed as required by law, botb tbe mmer and contractor laY be cited for a lisdeJeallOr violation under state law. If tbe mmer or intended contractor are uncertain as to wbat licensing reguireJeDts laY apply for tbe intended IIOrt, tbey are advised to contact tbe City of Zepbyrbills Building Departlent, (813) 788-6611. FurtberlOre, if tbe OIlIer bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe .Contractor Sectionsl of tbis application for wbieb tbey will be responsible. If JOU, as tbe OIIIler sign as tbe contractor, you are indicating that you, ratber than tbe contractor, are responsible for tbe IIOrk. If tbe contractor wiabes you to sign as contractor tbat laY be an indication that be is not properly licensed and is not entitled to peIJitting privileges in tbe City of Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, tbe applicant, bave been provided witb a copy of IFlorida's construction Lien Law - lkIIeoImer's Protection Guidel prepared by tbe Florida Departlent of Agriculture and ConsUlel' Affairs. If tbe applicant is SOJeODe otber than tbe lOIIIlerl, I certify tbat I bave obtained a copy of tbe above described dOCUleDt and pr~ise in good faitb to deliver it to tbe Rovnerl prior to co.enCeJ8J\t. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all tbe infoIJation in tbis application is accurate and that allllOrt will be done in COJpliance witb all applicable la1l8 regulating construction, loning, and land developaent. Application is bereby Jade to obtain a petlit to do IIOrk and installation as indicated. I certify tbat no IIOrk or installation bas ~ced prior to issuance of a petlit and that allllOrk will be perfoIlecl to leet standards of all laws regulating construction, City codes, loning regulations, and land developleDt regulations in tbe jurisdiction. I also certify tbat I understand tbat tbe regulations of other goveruental agencies laY apply to tbe intendeclllOrt, and tbat it is IY responsibility to identify wbat actions I lUSt take to be in COJpliance. Sueb agencies include but are not lilited to: t Departlent of EnvirOlll8lltal Regulation - Cypress Baybeads, Wetland Areas' and InnroDleDtally Sensitive Lands, Water /IIaste1later Ireatlent t Soutbwest Florida Water Managl!leDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArJy Corps of Engineers - Seawalls, Docks, lavigable Waterways t Departlent of Healtb i Rebabilitative Services, EnvirODleDtal Healtb Unit - Wells, Wastewater Ireatlent, Septic !ants t US EnvirODleDtal Protection Agency - Asbestos abateJeDt I also certify tbat, if fill laterial is to be used in Flood Zone IAI or IA,etc.", it is understood that a drainage plan addressing a lC0JPeD8ating VOlUleR will be sublitted wbieb is prepared by a professional engineer registered in tbe State of Florida prior to peIlit issuance. '7 SIAIE OF FLORIDA j, CoomOF /45~ The foregoing inst~t was a~kooWledged before me this 3~ ,19' ~{ by . . SIAIE OF FLORIDA 0 coum OF 1 /tS Cd The foregoing inst~ent was aC~~edged before me this g -;5K- , 19 ~ by who is personally known to me or who has produced as identifi~ '~., 0 did/did n.ot take an o~th __ /. . 67 (/J _ c..--/ _ ~(2..J -' (Signature) /1 ~ .//.L' . ~ I tlf L€)~;f (Hame Typed, Printed or Stamped) HOTARY PUBLIC N Publ' P C Ft otary Ie alCO 0, My Commission Expires May 13. 1995 who is personally known to me or who has produced as identification ~~hO take an oath. . k/ (Signature) !K6i77f G~/rr_ (Hame. Typed, Printed or Stamped) NOTARY PUBLIC Normy Public Pasco Co, FL My Commission Expires May 13. 1995