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<br />DEC-0'9-' 9..' FP.'. ,5: 06 ::>: <br /> <br />"''EL 1',10: <br /> <br />"08"< P02 <br /> <br />CORDI'l'IOIIS OF PERMIT AFfIDAVIT <br />A. lfO'I'ICII OF I*&D RS8T1UC'l'IONS <br />ftI lIIII!Int,. ...... ~t tIIu JIIIIlt ., ba IIIb2ICt tlI ..... rutrlcU.. alii IIJ' III .. Ultrlatlft U. C:ltr <br />r......... ............... ft111111111JI11!q Iar ~li1a. ,itll UJ ."Uwll ... rlltrl..... <br /> <br />a. UllL1CKllSBD COIft'RAC'l'OlI8 AJID COlRMCTOR RSSPOH8X8ILZTIB8 <br />If tfI8 11IIIII' .... Un4 IlllIItraeblr Ill' llCIIItnI:tIlrI tIlllllOrUU 1IIIrl, Uer III III ~ tD III II..... la .......lit/a <br />ltate _ 1_ qpIatl.... If tR lIlIItnetar III111t 11anId . npInd Ilf III, IIatII tM .. ... 1IIItra.., . <br />eibd flit . .i...... riollticID \Ill)It tWl111t. If tile IlIUt or Iltll1lW CIItractor Ira IHIrtIII . to lIIIIt llealng <br />rtlJI11net1 ., ",I, for tIIIlnteaded wor):, tber an IIdmed tD ~ t}& eft)' Of ~l1Il1dlMGO ~,(1I13l <br />7IH611. <br /> <br />l'IirtJIIr.., If UII .. .. 1I1lw;J . c:IiIItrlCblr DC l,'GIItrKbKl, .. 1. 14,1114 to .... tal CGlttIl:tOr(l) 1111 __ of tile <br />"Ct1lItfld:ac BKU.I. 01 WI ~t.Wa fIR IIIII.cb tiler iQJ1 .bt ntpuQiblf. If fOIl. .. ue .. till. till ~lttl)t, <br />JtlU In illdlCltlll ttIt *, I'lItIIIr t:JIIn tile ('.lllItnctDr, IrI reapouilll. fat tat ... [f tM atrletlr vI_ .. to dgII <br />. CGIItnctlIr t:IIat .., ~ .. lD(I1eat1111 tIIIt III II IIIlt: prDpIIrJr JitlUllllD4 il IIOt aatithl to JHIlttlll lIi"l" III till <br />Citr Of ......111. <br /> <br />C:. TRAR8POR'l'JlTIOR UlPACT FDB ARD UTILl'l'Y CONltBC'l'UJJ( :nms <br /> <br />D. ~ (CHAPTER 713. rLORIDA STAftITU# AS AHUDBDJ <br />1 wt1f, ~ pnriilld litb . I:GPJ IIf .fiDEliIII', COaItnctJaI Llaa LIt - ~'. rtotIct1oIl <br />gwa. )lt1pll:14 -, ~'lor* .tMI.t of Igrlwwl lid CauuIK !ffllrl. If tie Iftneat II ..... otMr tMIl tile <br />0_0. 1 Clrur, UIiIt I ... ~ iI l.'IIpf III tbI iIIIDf. MluD14 dIIcuIIIt 1M pr.... II _ f.lt~ tt -.u... it to tIIlI <br />.__ "lor ta - t. <br /> <br />1:. lDAV <br />I ,*Ufr 11III' RllIItlte u4 tUt 111llllk .mlle .... la .......... nUl all <br />iIlP1Jeeldt 1M aplaUIIg cat.aIcUGll, 1GAlIg. .. 111II ...~ <br />Ipplleau. II .. .. l,g llIMiA . PlRit l.lIlIu IIlCk 11I4 illll;&ll.t_ .. idcaW. I cuUfJ .t .. _k III: <br />1IlILa11.u. -. __ pdot \0 --. Df I ..t ... tIIIt 111 Rl nil .. ..,.... ta .... ........ af II1l _ <br />regW.lWv ..tnaUaa, ell, ....., aiIIjJ nplltllIU, ... laIIII iIml..t nplathu .. ~ ju........ I q <br />l!IItlfr tIIat I.." tiat tilt ~ of DtIler.,..,..uJ ""1111I QfI, to tM ....... .. .. it i. <br />If fIIPIIUlMllty to UIIlWJ .t tct10IIIl _ tiki to be iI ClJlplluct. lid IgIIC1a lid'" ~ tit lOt 111SttI to: <br />t lleIle!WIt of !nlr-.' IllalUt1IID . trPnM ..,..... let... Ie... 11I4 ..,a.-tIIl, -.a1U" LaII, <br />1IIta/lllltMtlr It... <br />· Sf!at_t. florldl ..... ........t DUttict . IIIJII. CrllAI' ..,....., 1llUU4 Inu. J1tvllt ..~~ <br />t -a If IIld!!Im - ....11, ~. llfillDl' IWaIara " <br />· ~ __ If 1IiliiI1lllllb!1Jtat111 IItnSCII. I'lWkGMllt&lIeUU III1t . 1Itl1l, WIItMtk IttItIIIt, ...C r_ <br />t us lid. ~ 111!9 . IIbeItOI ~ <br />I II.. cUt tIIIt, if fW IIUrW II to N lIIII4 II '1004 IlIII "I. or "I,tte.', it it OQtItqtooil tIIIt . ~ ,lID <br />*nlliIg . "ffllliHUIlI .01.. IItIl III ..lllIittld IIII~ I, pnpuld III , pmfwWd ..... rtlbtm4 II tM lUll of <br />nor." prlet to panit J~. . <br />. ~rtit iIaI! *1l11t I:IlIIItnIll tlI lie . Urme to 1IMCeed llltb till .. IIId DOt .. 1lItIlar1tr to YioJItI, CIIaIlI1W. oc <br />lit IIi..., proriI1GlII !If tM tKMICIl COdIII, IIOt *11 u.u.a Of j PI31t (lQtlDt UIt IWWIIg lIW.ciIl rr. filnl(tac <br />r~dIg Il:GaICtlllIl Of ImlR 11 pi...., rGUtneUaI. IX ,lolItlalQllIf 11I7.... .., Jlllit ... IMU ~ ...l1i4 <br />11II111 tM lid IIIUIIIlI8IIllr _ gait i& -.ad .1Uiill..iJ 1IIItIII1If bmmI, or if at ..lIIlt ., tile f'QIlt I, <br />...,.... I( ~ far; I pdlll1 at ah ... IltIr tM till ~ _~ 1I......e. 011II to .., ..... II. till, ., lit <br />all_ fRliII....t Ittb f. .. or '15.0'. ne at..iGD..U bII ~ i&lldtill to tIlIlIa1WtIsI llmcW. II <br />..... ..... .. be lcgge4 MdDI.a ISa .. .104. at ~ projld; .w 1M __.. ....... <br />IIDlIG 10 _: _... 10 1,I.1lIIlIIDI'ICI Of ~ 111 BIlL' D 1C111I!IIl lID .. .-ra ro IClllI <br />PIJIIm. 1I11111111111!D 11IIII 'fDIi:IK, aIUILt I1D1IiI .. Gill uam ... ....11I ,. 1lI1C1 or <br /> <br />7':~~-._~~ <br /> <br />ii~ 01 11..-: QIIrIIL"D , <br /> <br /> <br />. 'State Of <br />iillofitia. My Commlla1on <br />fEarptm:,September 29. 19ge. <br />Commi'$lon#OC 226123 <br /> <br /> <br />p <br />..1datifiCII" tim1,1S, 4l~dld DOt <br />~.~ <br />(8 re) <br /> <br />(=..~ .tl~lv o. COMBS <br />.'..--- ~ NOTARY PUBl.IC, State Of <br />~ (')r Florida, My Commission <br />\~ ~ i) EXpires: S"pt0mber 29, 1996. <br />"':r..~o~ C0mmisuon :ft;CC 225123 <br />.........nf" r;\ <br />