|
<br />OCT-05-'95 cRI 13:33 IC:
<br />
<br />TEl. HO:
<br />
<br />1*217 P02
<br />
<br />CONDITIONS OF PBRMIT aFFIDAVIT
<br />A. !liICB~ RBB~IONS
<br />lilt .... .... tbat ~.. .., IlllUbteet to "1IIId rettdctiou. "I~ ., be IlIEe IUtrlcth. tMa Clll
<br />"....tt_. n. ~ ...... r.....l.W1tJ far CllIl1ll11D rUb aa, _Uabla dII4 rlltrlcUoM.
<br />
<br />
<br />hrUmort, if tile - 1Iu lind a ClIItrlctor or CllIItractDn, be illdwia4 to .,. UI ClIItrIctor(.) .ip portIGU of UI
<br />.CGltrctGr 8Il:t.1aaI" III W. ."UCltIGI for 1lb1c11 tlIIr 11111 be l'IIPIDIiJIll. If fllU, II Ue .. .lp .. UlIlIItrICtOr,
<br />JlIlI .. IIlticIt1Il1 tat p, ratau ~ tile CllIIt."ICtllr, arl rllpoulbll for eM c. [f tba ClIItrICtw IIWaI J8I to .Sp
<br />.. ClllIltrICtllr tIIIt .., III .. billCltilll tlIIt III illlDt pnperl, licwa u4 lJ lOt uUU" to JUIlttbt prlwi..... II Ut
<br />Citr f1f ......Zla.
<br />
<br />C. 'l'1WISPORTATIOJf IMPACT FIBS AJC1) U'l'ILI'lY COltNBC'llOJf 1'188
<br />
<br />D. COII8'l'~ION LID ~ CCllAPTBR 713, FLORIDA STATUTBS, AS AIIBIIDED)
<br />I ..tIf, un, lIIP1ielllt, 11Ift proai... willi. CGpy of "florida'. CatracU. u. ... . ......'. PratIcticIG
<br />IilIldI" pnfIIIl1 br tile nod" hpartMIt of Agriculture IJld ec.-r Affai". I[ ~ 1IP1lC11t II _ ok tMI tile
<br />.llIIIIf", [ certify tIIIt I 11Ift .ai_. copy of tile ... dlleribe4 m-t ... prom., s, IOlll1 fait) to Wi.. It to tile
<br />'oIIv" prior to --to
<br />
<br />B. ~'8/~'8 "prIDAVIT
<br />1 CIrtUf all JafOnllt In tIda lflllil:lti. Sa lCCI1'atllJld tbat IU m 111111I_ iD _iallltIl all
<br />wlleIbll 1_ npJIUIt ClIIItrIICUllll, 1IlIl11l1, IIIl1 Iud .......t.
<br />
<br />_liCltI. I. ..., ..,. to abtaill I pmlt to " 1ICI1'~ .. i..ta111tJllll .. illUeW4. I cutlfr tMt . 1llIrk Dr
<br />illltllJltllll ... ~ ll'1ar to Ianace Of . pmlt ., tIlet III *' _ill III pwfDrllll to lilt ItI*rU of all 1_
<br />regglltlag QlIlItrIIcU86, Clt, ...., IOIIlag ragulaUClllI, _ llIIl1 .IIGplDt r.....U.. b tK jurWlcUal. I al.
<br />arttf, lilt 1 1IIIIntIad tbat tba rlplltlaq of otIIIr peI...uJ ...cllI II, tppl, to tK iIt.W _k, ... tUt It iI
<br />If r.....illlUtr to fdlltif, ..t IeUGIII I IIIIt WI to lit ill ClIIpUIICI. W..... 1Dc1_ lllIt In aot lJaitld to:
<br />· lIeJett.t ollllriro.atll ..latillll - ~ ..,....., IItlaI6 Jr.. 1IIl111w1~, laiU.. LIaII,
<br />lItIr/Vlltlntll tna_t
<br />t t n.r trict . lilli, Cypma ...., IIItllDd AntI, I1tarllt ~
<br />t I, bu, 'ul_1e 1latmIJI
<br />· 'ardcu .... t . IeUI, _mIler fnItMl, IlpUc IIDb
<br />· . Wutoa t
<br />I . , I r 11.1.1 II ta be _ iD Flood IoIe ".. or "1,lte.", It lIl11ldautaDd UIt a dr._ ,lu
<br />Idd,.ug . .........U.. __" _ill III aablitted -.tcb il ptepI1'llI b, . profeaafOllI lIgilllr nglatutd 11 tM .tItI of
<br />floti41 (ldDr ta ,arJlit ianacI.
<br />
<br />I penJt i.... ..U be CXlIIItruIII to be . Ifceue to prOCtld litll tbllllllt IlId llOt u HtIlor1tr to riolata, caell1ter, or
<br />lit IIi. .., PMlIIaaa f1f tbI tlclajca1 cod., IIOf "'11 1--. of I PIl'Iit prtftIt tM laUdllt Dfflc1eJ 'rei ~tIr
<br />nwalr'" I etrnctiaII of arron II plllll, CllllItruCU., or v1011tiCllll of ., _. ..., palt J..... ....1 __ fDftlld
<br />1111... tM lIllrl IUtlllIdalll ., .udi puIlt la __ rlt1l1o UI aU. of I....., or If IOtl auuor.... ... UI flalt i.
<br />...,..... or ..... 'Ot I JIId04 of Ib atIIIlftlr till U. tile _~ II~. au II .., ..... of u.. II, III
<br />111_ far tlIt pemlt .l~ r.. .. of tlS.GO. IIle eatwlaa ",UIlI ~ ill.lt1ng to tJlall1Wag Offldll. All
<br />IpUftlJ 1aIpacU. at III loggea 8iDg _ iii atll peri04, or tK ptOjllCt rW lit ClIIIIIdIna ........
<br />_118 10 MIl: .. 'lu.III III .all) I IDrICl Of ,,_lit... lllIY ...., 1111III PlYJIC IIfJCI .. ~-dI III YIUl
<br />IIIIIIJ. U" UIIII to lIrm rman, lmIULI UII .. mill ~ U .,.. ... --.. ftI8 IIJCI ,.
<br />--.. -_.....,,_........_.._~.
<br />
<br />
<br />
<br />'IGIIIIII: ... 01 - IlliIIllIII:
<br />
<br />111ft tf MIDI
<br />lDIft or
<br />ft, foregro1n9 iD.t~t INI. acbcetledged
<br />before _ tbl. , 19_ by
<br />
<br />1tbo ia pencaal1r __ to lie or vbo bu
<br />proda9d
<br />.. ldentlfloatloa aDd wbo did/did Dot
<br />~Il. _ ..tb.
<br />
<br />
<br />(ligature)
<br />(... TJped, PriDted or Su.ped)
<br />_BY PUlLIC
<br />
<br />
|