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<br />CCi'JD;. .-:C C.<~ DF Pl':T:i'i I T ('\['-r-..l
<br />
<br />....) y
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<br />A. NOTICE OF nFE~ RESTRICTION~
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<br />The und~r5ignrd und~r5lands t~JI thi~ per~it mJY b~ subJrct to "dred restrictions' Mhich nay br 00rr r~slrictiv~ Ihan City
<br />regulati~ns. 1he undcrsignrct "ssu~r; responslbllHf;rcr.co~,pli~nce llith Jny applic<lble deed rr:s1ridions.
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<br />E. UNL T CEf\ISED CQI;rrSD__C:TORS AND CONTRACTOR RESPQf.:IS I fJ I LIT I ~5
<br />
<br />If the o~nrr has hired a contractor or cDntr~ctors to und~rtJk~ Mort, they may be required to br licrnsrd in acc~rd~ner Hilh
<br />~tate and local regulations. If the cDntractor Is not licensed ~s rcquircd by laM, bolh tbe o"ncr and CDnlrJclDr nay br
<br />clled for a ~isde~ranDr violatiDn under state law.. If the OHner or Intended contractor are uncrrtain as 10 Hhal liCEnsing
<br />require:ents ~ay apply for the intended wDrk, they are ~dvised to contact the City of Zrphyrhills Puilding D~part~2nl, (513)
<br />788--6611.
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<br />FurthercDre, if the OMner has hired a contractor or contractors, h~ is adyis~d to have the contract~r(s) sign portiDns of Ihe
<br />'Contractor Sections' of this application for Mhich th~y will be responsible. If you, as the Olln~r sIgn a5 lhr c~nlracIDr,
<br />YDU ire indicatin~ that you, rath~r than the contractor, arc responsible for the Mork. If the (Dntra:tor nish2s y0u to sign
<br />as cDntractor that cay be an indicatiDn that he is not properly licenscd ~nd is not entilled t~ p~rQilling privilr~~5 i~ thc
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTAT I ON H1PACT FEES AND UT I L I TY COI'If\IFCT LQJ"'.I F[r::~
<br />
<br />D.
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<br />CONSTIlUCT I 0['1 1_ I ~J::l_J.J~\,J
<br />
<br />(CHAPTER 713. FLORID~ STATUTES, AS ~MENDED)
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<br />I certify that I, the applicant, have been provi~ed with a copy Df "Florida's CDnstrucliDn Lien LaM - \lo~eown2r's Protection
<br />Guide' prepared by the FI~rlda DeparL~rnt Df Rgrlculture and Consumer Affairs. If the ~pplican\ is s~=e6ne other Ihan the
<br />'owner', I certify that I j;,,'le c,blained a. co'py of thl! above described de,cument "nd prc'IT,ice in good faitt, \0 ~eli'{cr it Ic, the
<br />'owner' prior to co~~ence~r:nt.
<br />~ '. .:' .::. ", ' : : .
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<br />E. CONTR~CTOR '8!I\\-JND3' S AFF IDAV I T
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<br />I certiry that all the infor~atiDn in this application is accurate and that all Mork "ill be d0ne in coapliance with all
<br />applicable laMS r~gulaling c~nstruction, zoning, and land developDent.
<br />
<br />ApplicatiDn is hereby !a~~ 10 Dbtain a per~it to.d~ ~ork and installation as indicated. I certify that no work Dr
<br />installation has cD!!onc~d prior to issuance of a per~it and that all work will be perfDrDed to leet standards of all laws
<br />regulating cDnstruction, City [odes, zDning regulatiDns, and land develop~ent regulati~ns in !ho jurisdiction. I alsD
<br />certify that I urderstand thaI th2 regulations of ~ther governDental agencies may apply to t~D into~dEd Mork, arj thil it is
<br />ey responsibility tc, ide;,t!f)' ,i~,al a[l;ions I ~\lst tal:e to be in CClmpllance. Sucl, a~er,cies includE t"t\ ~\D IiC,t lir.ilod 10:
<br />
<br />, --
<br />I DeDar\~ent (,f Envirr.n~r:D1JJJ!.!:nl.11~ti(ln - Cypress Dayhrads, Hetland nreas and Efl'lirc,nc!c.,lally SEnsi tii~ l:lilds,
<br />\Iater/\laste~ater Treatment
<br />I Se,ulhwost F].Qilqa \b~r_l\,'l!;'-[I~..:\,:..'!~~istrict - \Jells; Cypress Dayhearls, Hetl,jnd r,reas, rdlciing ';l::lerc~urses
<br />I Any C(,rosof .EI;gjJ:';::i'i;, - Se,'lIi111s, D(,cks, Havigable HateTlJays
<br />I DDP"rt~~,-.ci.-I!palJ.!0'_:'::c),,!~LI:,l:;ti'lp. Services, tnvirDn~,ent;;1 He,,\th linit - \ldls, \l"stcw2tEr Treat,:-:,,'.. Septic
<br />I US E flV i rs:~'l,,--:JrJ,"\,-~Ui2r,_~.G..r:1. - rlSb~5 tos aba tem~nt
<br />
<br />T"nks
<br />
<br />alsD certify that, if fill r,aleri;:.l is to be used in Fl'c,~d Zone "nO or "n,c\c.', il is untlc.rctH,d t:.~t a drain2.ge plan
<br />addressing a 'cocpr:nsatinQ ~Dlule' Mill be suh~itt~d which is prepared by a profrssiDnd\ r:ngin~Lr r0~i5l~r0J in Ihe Slale Df
<br />Florida pri(,r to per~it iS5',!,I,'(['.
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<br />f\ perti! issuod shall br: ccr,slrued to be a license to proceed \lith the "HI: ilnd n(,t J', ;;\Ithc"i\y ~,c' \'i(,let~, cancel alter, Dr
<br />set asi~e any provisions Df the technic;;l codes, nor shall Issuance of a permit prevenl the Duilding 8fri(j~1 ir~1 thereafter
<br />requirinQ a C('Hectic,r, tof errors in plans; onsiructi(,n, (Ir vie,lations of all(' [c,[]e. ['.'CI-Y rc-f;;) t iS511d O~,"J 1 beee'fe' in':alid
<br />unlrss the wHk 2u\l,c,ri;ed by silch perillit is ce'llI~enced Mithin six ilIonths (,f issu.1r,,:e, ('I' if II~,JI. ::\1\1,:,\ I;(.j b)' t~;c (ErAi! is
<br />suspendd or "bande,nod f[,r a perioll e,f six ~onths after the t'j~e the \IDr\: is u,r.,Ii,enced. D,",e ~(; Gay c.~\::r,ci('" of ti;e, ~ay be
<br />all('Hcd fc,r the perr,it flith fe~ charge of $15.00. The extension shall be requested in \,ri\ir:~ 1(, tI:l' 2.-,i\din~ Official. li~
<br />apprD'ied ins(Jec\i(,n rJust be le'gged during each six month period, or the pre,il'd Hi 1] lie c[<f,siderd "t,,jl,GC'i,C.d.
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<br />\.-JARN I NG TO OvJi\lER: YOUR FA I LURE TO RECORD A f\IOT I CE or=- COl'll'\E:I.IL:E~lEr~T t.1AY
<br />RESULT IN YOun Pr\Y I NG T1,...1I CE FOR I MPROVEMENTS TO YOUF< fJF<OPEFn'(. I F YOU
<br />INTEND TO 08TAHI FII\IANCING, CONSULT v.JITH YOUR LEf\JDr:R UR r:\N ATTORNEY
<br />BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOGS UNOER ~2,500 IN VALUE
<br />DO NOT NEED TO RECOrm AND POST A "NOT I CE OF cm1r'1l::f\ICE:I'lE~H".
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<br />C4.l ~-:/~. )'.. v/ /7 ~/ ..,~
<br />SIGNATURE____r.';i.::. '_ ______ _____________ SIGNATUnE~_~--- --------------,
<br />,I' ;\IN,," or. AG' NT PE K"",,JAU-Y KJJ""N COol 1 "ACT < PEl'S N}fil-LJ' ,,;.), MJ
<br />
<br />DATE__________~:~~~S-~--~-~-----.------- DATE__________L:~-G?-~~JQ---------------
<br />
<br />NOTARY AS TO .' A1
<br />OWNER OR AGENT__~~~--Q~-.~. _c~~
<br />/.( 4tH L.&~ 1,..) r B R. D "...)lv
<br />MY COMMISSION EXPInES___________________~_~
<br />
<br />NOTARY AS TO, -:J ~
<br />CONTRACTOR____~*j~ ,--~tZ-~
<br />... KkrHL-ErG.JJ. _<Bi20w/'..J
<br />MY COMMISSION EXPIRES__________________
<br />
<br />~..'io~ PUll
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<br />
<br />'I~ Of f\.O~
<br />
<br />KATHLEEN J BROWN
<br />My comrnlMiiO" CC449029
<br />expn. Apr. 02.1999
<br />Boflded by NFNU .
<br />8C)O..22A.e368
<br />
<br />~..'ioy PIIIl
<br />
<br />;.~
<br />QI~ ~
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<br />. 'Of ,\0'"
<br />
<br />KATHLEEN J BROWN
<br />My CornmIMIon CC44G029
<br />Expir_ Apr. 02. 1e99
<br />Bonded ~ NFNU
<br />800-224-6368 .
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