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<br />, COND~T~O~S OFPEijKI~,AFFID~V~T
<br />A. UO'l'ICE OF DEEDRESTRIC'l'IONS' " , ' " ' .
<br />!be &iDdiu:aigne4 UIlderataD4a~ttbia.~tIiY be subject to ldeed reatrictiOll8I'wbieb iii be lOre, natri~ti'etbaD ,City
<br />regubt;iona. IlIe UDdIJrIi!Pl84 ~,J:ea~8ibnltr for COIIpl~ .1tb jIlr, a~pUcable clee4 reatrictiooa. ' '
<br />
<br />B. UNLICENSED' CONTRACTORS AND CONTRACTOR' RESPONSIBILI.TIES ',. "
<br />If tlMi i*Def baa bitlll I watractocor ~tnctora to Ulldertake IIOrk, ther IaYN rlCluired to be lic:uae4 la' ~ Mith
<br />atate culd local reguliti~.~', If tbec:optrac;tor la. IIOt licuaecl II requin4br laM, botb ~.,~ iUlll.CQIlt;pc~ IIlrbe
<br />cited fur a .i~[ .JiOlitiOD_ statel.. If the 0ImU or inteo4ed COIltractor are' uiiCertaiD astowmat' li~uaing
<br />requil e1IalU litr apply for the inteDiw *k,they are adviae4 to contact, the City of ZepbrrAil1a BuildiDg De~~, (813)
<br />188-6U1. . " ' ';. '...' ' ."..y",.... ,
<br />
<br />. ,
<br />PurtbulIOre, if the ... baa Drecl a cootractor or contractorl, be ia il4vilecl to bav. the contractor(s) aip portiQD8 o~ the '
<br />IConbactoc Secuooal of tIai. ippllettiQll for vbieb',ther .ill be reaponeible. If fOIl, as the o.mer Ii~ ...tJle~~~~" ,
<br />YOIl iLl' iDdicatiDg tbit,JOU, ratJlertbaa tile cootractor, are rUpODiule for t;be lmk. If the CODtractor .iabealO'l,to,ip, "
<br />II CWjtcactor that lif ,beinWicaq~, tbat be il DOt properly licuaedand la IIOt eDtitleel to peraittingptivi,leg,,),O,' we
<br />City (It Z8pbyrbilla.':'. " .~'::~""~:~" " " """" "":'i...;)":,'f':"'"
<br />
<br />C. ~rRANSPORTA'l'ION IMPACT. FEES AND UTILITY CONNECTION FEES
<br />
<br />D. ~~ONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STA'l'UTES, AS'AHENP~l. .
<br />I certify ~t l,tbe.iPPliCillt,bavebeel1 pmicleclldtb it copr of .'loridil'a CODa~tiDll LieD Law .. ~erl.,'J:Qtec:UOll' .
<br />Guide.' :preparecl by t;bf"loddi., JlepirtleDt of Agriculture aDd Colla,*, Affaira. If tba appUCilDt ia IOMOIUl otbu thiD ,.tJMt '
<br />lownerl, 1 certifr.~t 1, .,..~ ii' c:opr of tbe above deauibed docUIIeAt aDd prDliae in goodfaitb to de1her it to ~
<br />lowner. prior to, COIIWoceleDt. ':. : . ' .' . ,'. ." " " .' "
<br />
<br />'.,;',,1" .,' . "
<br />
<br />
<br />'('.-:-:.' .
<br />
<br />E. !::ON'l'RAC'l'OR IS/OWNER' 5 . AFFIDAVIT , "
<br />1 cerLHy ~t ~Utbe:W~tioA.~ tILQ.ilpplicatiDll. iaaccurate aDdtllataJ,1 wk will be '.~'in Coipliauce' ..ltb'iall
<br />applil:able 1_ regulitiDg ~~~~;~~!~~,:~,,~~,~'el~pleDt. " . . .' . .,
<br />~ppliL~tiOll is.btreIJr.f.iIde'.~Ob~'~,~l~~to,~~k. iDataUilUOIl II~~:~. ,IcerPfy tbatQO IfOItor.." ' .
<br />1DItaH~tiQll Ilia ~~.pd~:~,~_.OAC:~,.qf"i:~t',iD4' ,tbit ill'~k 'ill. ~l~.w,-t .~ of~.~._,' .
<br />Ie~i~t1Dg conatrucUQJl," City~f~~~~~POlll, iD41jlX) develQ~~~J~iti* in tile juriac1.ictioA.. I illO (.. ':"" ,
<br />certi,i:J ~t I ~taD!l that tIior,gulitiCiDl' of'.othetgo'lltIlIeDtalagllDCilllitrapplJ totlae intellde4 10ft, iIld tbat it is
<br />.Y relJponauiUty toideDtifjllbat ac:Uixla I IWit ~ to ~. in CQlplillice. sucla igeDClll1nclude blat I{e DOt liaited to:'
<br />t !!!!ltJent of BnvirDlllel1tal R8J.Ulation .. Cypreaa Blrbeada, WetlaDd Areil iIld anviIOllleAtaUr $eDliUve LaIlda,
<br />, ,;',: ',~ ' 'Mater/Maateliter lIea_t '. .
<br />t Sou I;!!lrIeat rloridil Mater __t' District.. Mella, ClPreaa Baybeada, Metland. Areaa, Alteriilg tlatercoursea
<br />· !f!l Corps of Ingineen .. S.....la~DocU, 'av~gable Matenara
<br />t ~~Itaent of Healtb " Rebabilitative Senicea, BnvirOllleDtal Bealtb Unit.. MellI, ~tewiter lIeatleDt, Septic'liDb
<br />. !!!.,I~.!YirOOJental Protection Agency . Aabeatoa ibituent. '
<br />I wo certify tbi~, U,.uUljtu~ ia to be _ ill Flood _ IAI or Il,ete. I, it ia underatood ~t a draiAage plill '
<br />addreaiing a I~D8itiDg ,o1..'"ill be l\JbIitte4llbieb II prepareel br a pl'ofeaaiODal eDgiDeer regiatereel in the State of
<br />Flori~l prior to peqit, iao~~ ::':.".~.." . ,
<br />A ~.Lt iaaued aball be CODatn&ed. tq lie i'UCeD&8 to proceed with the MOrk ID4 DOt ii authority to ,lolite, CilDCd alter, or
<br />Itet ijaida anI proviaioDl of thJ tecbD1cal c:odea, nor aball iaauauce of i perait preveDt tbe Building Official fral tbu:eafter
<br />requiring il correeUGAof error. iIa:p1.-, CQD8tnctiOll, or ,iolatioaa of anI CQC1e. IvGrJ pmit iaauec11baU becOIe ,invalid
<br />Wlleu tbe lOfk ill~ial4JI' luQ (lUIit is ~n,;:ed IdtbiD aUlODtbI of iaauilAce, or if..MQ(k illtbodleel by tlie peIllit is
<br />Sll8pttldcd or iIbi~ for i ~iocl of ail a* after the U. tbe lmk la COMUced. . lU 90' day uteAaiDll ot tile, ailY be
<br />allo.rlld for tbI peqit witla fee dlarve of $15.00. rhe uteDaiDll aball be requested in ll'iUng to the Building Official. An
<br />appnlvoo iDapecUOD JUSt be logged during eacb wlODtIa period, or'the project wiU, be conaidereel aba.~.
<br />WAJUfl IIti 'fO 0II1f11: 'fO IICOIID I IOJICI 01' 'CXIfHDCIHIft IlAY BiSULr II YOUR P1YlIiG !WI IHPBOVIDII'tS 'fO YOUi
<br />PBOPU1IY. II Qf , , COISOLf "WIIB YOUR LBIIDiR' OR .. lJIG lIOfICI 01 '
<br />COKHli:II' . . ~: JZ,51t AWi DO Of QID 'fO tw:ORD UD POSt I.'
<br />
<br />
<br />
<br />) j> 1., I
<br />
<br />StAtH OF FLOi1DA \ ~ ., . '
<br />COWI~rr OF P A.se i> .
<br />'rhe foregoing iDatI'UlKUlt,was acknowledged
<br />beff)l'e 1I~,~i~,.':'&A~II'3.D'.,! ,~19~bY , '
<br />
<br />. ' _', , ':' ?; -'10 ",;.' ,'.- :'~ ',- i . _. ',~ ..i '
<br />----E.,A y '~'-D'A iJ/ttLS ' . ".., " , .
<br />who j,s personally mown to .e er wao, hu
<br />'I'srllileed ' .
<br />H l~OAtifi.~iea .iUlcl ..~~/di4 ~t ,
<br />
<br />:::~~~:~~~ ...
<br />(NalH: Typed, P~iD:tecl or ~taaped)
<br />!!Q!{Y!:Y PUBLI.C..:' -<. . ., i'
<br />
<br />. stArl or FLOIllOl
<br />coumOF -f'A5eo
<br />The foregoing iDstrwaeDt was acknowlCitdgec1
<br />before lIIe this I1IlRfrif Jlo , 19 qC; by
<br />
<br />RAy ~])A1JlE1-S
<br />who is personally known to IIG -81' ~lu h..A.
<br />'precltteed- .
<br />.. id8Rtifi~atiQB and wbo~/did not
<br />
<br />::::~~'v~J~
<br />(Name '~ed, Printed or Stamped)
<br />NO'fARY PUBLIC
<br />
<br />~...,.I "lIk(
<br />~6~
<br />*IliiJ/!*
<br />
<br />"''''~'~''
<br />""E OF F\.~"'''
<br />
<br />kATHLE$IlJ BAOWN
<br />My CornmlnlOn CC",,9029
<br />EllpifeS Af*. 02; 1999'
<br />'Bonded by NFNU
<br />800-224-6368
<br />
<br />~...,.1 'lIk(
<br />~6"t'
<br />*~*
<br />
<br />''''~-~~
<br />""E OF f\.~F
<br />
<br />KATHLEEN J BROWN
<br />My eornrnlnlon CC449029
<br />Ellpires Ar-. 02. 1999
<br />Bonded by NFNU
<br />800_224-6368
<br />
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