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<br />CCi'lD :::.-1 r-"',i(:~ OF PC::,';!'; I T r,rcfo'.l
<br />
<br />,\.' ,~ y
<br />
<br />A. NOTICE OF D~En RES-rRICTIONS
<br />
<br />The undersigned understands IhJt \hi~ perDit mJY b~ sublect to "deed restrictions" which ~ay be ~0re restrictive th~n Cily
<br />regulali~ns. Th~ undersigned ,:5su~e5 re5ponsiblllt{;for,cor.pliance Hlth any appliC<lble !lec!] re,IricliCo:1s.
<br />
<br />E. U~lL T CENSED Cl}NTRACTORS AND CONTRACTOR RESPQ!:!..f:1Jl~ I T I C::S
<br />
<br />If the owner hJ5 hired a contractor or contrJctors to undertJke Hork, they may be requir~J t~ be ]iccns~d in acc~,jance Mi:h
<br />state and IDcal regulatiDns. if the contractor 15 not licen5ed <IS required by IaN, both the ouncr and CDntr<lclor nay be
<br />cited for a nisdr~eanor violation under 5tate laM., If the OHner or intended conlr<lclor are uncertain as 10 "hal li~~nsin9
<br />require:ents ~ay apply fDr the intended Mork, they are Jdvised to cDntJct the Cily of Zephyrhills Building Dcrart~~nt, (5131
<br />788-6611.
<br />
<br />Furthercore, if the oxner has hired a contractor or contractors, he is advised to have the c~ntr~ct~r(s) sign p~rtiDns of the
<br />'Contractor SectiDns' of this application for ~hich they Hill be responsible. If YDU, as the ~"n~r sign as Ihe C0nlr~clor,
<br />you ~re indicatin~ that y~U, ralher than the contractor, are responsible for the H~r~. If the CGntract~r wishes y0u \D sign
<br />as cDnlr2ct~r th2t ~ay b~ an indication that he is not prDperly licensed ~nd is not entitled to p0r~itting priyilEg~5 i~ t~~
<br />Ci ty Df Zephyrhi lIs.
<br />
<br />C. TRANSPORTATION HiPACT FEES AND UTILITY COf\I!,Ir=:CTIg~:1 FEl::5.
<br />
<br />D.
<br />
<br />I certify that I, the appllcant, h~Ye been provl~ed with a copy of 'FIDrlda's C~nstructi~n Lien Lax - HG~eown~r's Protection
<br />
<br />CONSTRUCT I or:~I_Jo,lJ::rLL~\.ol
<br />
<br />(CH~PTER 713. FLORID~ STnTUTES, ns AMENDED)
<br />
<br />Guide' prepared by the F1Drlda
<br />'oHner', I certify that I li;,'1e
<br />'oNner' prior to co~~ence~r:nl.
<br />
<br />D~parlgent of Agriculture and Consu~er Affairs. If the applican\ is sD:~6ne other Ihan the
<br />~btained ~ c~py of the above described docuffient and prDmise in good faith to d~liycr it to the
<br />f
<br />
<br />~ ,":' .:~. ", ' : :
<br />
<br />E. CONTRACTOR ' ,8~m:lNF"R 'S AFF IDAV I T
<br />
<br />I certify that all the infDrl~\lon In this application is accurate and that all H~rk "ill be d0ne In c~~pliance wllh all
<br />applicable laMS regulating cDnstructi~n, zoning, and land developD~nt.
<br />
<br />ApplicatiDn is hereby ~a~c 10 obtain a per~it to'do Hork and InstallatiDn as indicated. I certify that no x~rk or
<br />installati~n has [~!'Dnc~~ prior tD issuance of a perall and that JIl H~rk Hill be perror~ed t~ meet standards Df all laws
<br />regulating c~n5tru[ti~nJ City c~de5, zoning regulatlDns, and land de'lelop~ent regulatiDns in the jurisdlctiDn. I alsD
<br />certify that I understand !hat the regulations of other governmental agencies may apply' tD the in\endej ~Drk, and ~hat it is
<br />ty responsibility te, inei/.iif ii~lat ;\[I;jons I t:I\lst tal:e to be in complianc!:. Such aser,cir:s irlc]ud~ t"d ~i e I,c,t lir.it~d \0:
<br />
<br />. ,-
<br />I Droart~Dnt e,f Envirnl~~:~jj;J Kr:~,l~tiDn - Cypress Bayheadsf Hetland Areas and Ef:'1if{'nr;,er:t2!ly SEn5jti','~ L:lil'j'f
<br />Hater/HasteHater Treatment
<br />I Se'\lthllest Flori,qa \I"~r-.-!:"i!.':.~g~_':.'!l.l~ - \Jells; Cypress !.\ayhearls, Hdland t.reas, r'\tc'rir,g ',i2!.crCDUrSDS
<br />I tIny Ce,rosof r~gji'lJ',~:, - ~;e,'ilal15, Dods, Havigable Ilaterllays
<br />I Departaent e,f l!c>"IJJd,_2U",hj)\tr:tivr Services, EnvinMlentallle;.!th linit - Ildls, \J,.s\e~Jtu Tre"t,:.::c~. S2ptic
<br />f US En'li r~I1~S'.~'i!.:.L?L'~ts_cJ,!c~rl,~.'!..Q.. - nsbestos abatement
<br />
<br />T ::nk s
<br />
<br />also certify that, if fill r,Jtr,ri;;1 15 to be used in FIMd Ze,ne On" elr 'n,etc.', it is \JfIdc,ret[<[,j \:,~t a Jrair,::ge plan
<br />addressing a 'coc?~nsatjng vDll1le' Nill be sub~itted which is prepared by a prof~5si~n~1 Dnglnn~r r0oi5l~(0J in the State of
<br />Florida priDr 10 p2r~it issuance.
<br />
<br />A pertit issued shall b~ construed to be a license to proc~ed "ilh the Hork and nDt ~5 authDrity t~ yi~i~t2, can~cl aller, or
<br />set aside any prc,vi5ie,ns Df the technical ce,de5, nor shall Issuance c,f a pl!rmit prevent the [Iuiidir,g Ll;'i\ci:,J jrc'~, thereafter
<br />requiring a ce,rreclie,n c,f urCJrs In plans; ce,nstructie,n, c,r vi~lations Df JII'! ((,de. Evc:\';, pc'r:iit iS5:1,',1 ,[,oJ1 b~CH,' invalid
<br />unless the )Je,rk au\hl,ri:~d b'l such perr..lt is ce,mr.enced Mithin six month5 e,f iSSUM,CC, c,r If IIC,1\; "I.tl"" i;d C)' \~,e ru~it is
<br />suspended or abar.GC'J)Dil fc,j" a perie,d (,f six ~onths aflH the tbe the IIDr~ is cc,r..rroenccd. l1i,e n,(1 d"y (';\':O,5\C'1I of tlH, aay be
<br />alle,xed fe,r the per~,it flith fce charge of $15.00. The extensie,n shlill be r!:r,ucst~d in l<ri\inD Ic, the c'Jildin; Offi:ial. Il~
<br />approved In5pec\ie,n Mist be le,gged during each six month period, e,r the pre,jl'ct lIill be cc,nsidcrc-d Cb"\ldc'i,~d.
<br />
<br />I,.IARN I NG TO OI,.Jf\lER: YOUR FA I LURE TO RECORD A [\10"1" I CI:: OF COf"1f"1t.::I-ll:Ei'lENT r'iAY
<br />RESULT IN YOUR P~YING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
<br />INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN Al'TORNEY
<br />BEFORE RECORD I f'lG YOUR N.DTI CE OF COMMENCEMENT. .10D~) ur'IDER '';.2,500 I N VALUE
<br />DO NOT NEED(4/TO..RECOE' / AND POST .A "NOTICE OF COO1I'IGICEI1G"."'~-
<br />
<br />
<br />SIGNATURE_c.t.------ ____________________ SIGNATURE_ ~~-~----~/ . ,
<br />7-r-~ <O'.'tlE r. AGENT ~=,<u-y ",),..'" 7---\mrmACTUiV f'E~SNU ftu.Y ~,v"",^,
<br />DATE ____________(t:.3:-qt2---.:.-c..-----,------- DATE _______t__~~_CZk- ------ - -- - - - -------
<br />
<br />~~~~~YO~SA~~NT--~~ Q~_~~~
<br />'J<lriiit.EE~ ~.BRtJ J1/AJ
<br />MY COMMISSION EXrIn~S_________--_----------
<br />
<br />NOTARY AS TO -f~,~# I?J
<br />CONTRACTOn____~k~- Q:.. ~
<br />k IrTll/..-ct=.)J J:t!B <'J VI'/!oJ
<br />'\
<br />MY Cm\~11 55 1 ON OP I RES __________________
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<br />*~*
<br />&fl/,~,"It'
<br />'''" ~~
<br />~ Of f\.\)
<br />
<br />KATHLEEN J BROWN
<br />My Commission CC449029
<br />Expires Apr, 02,1999
<br />Bonded by.Nr:N.U
<br />800:224-6368 .
<br />
<br />",~I'y PilI?
<br />...'" L>I.t'~(~
<br />* (*
<br />~ "
<br />""~' " ~<>
<br />. Of f\.\\
<br />
<br />KATHLEEN J BROWN
<br />My Commission CC449029
<br />Expires Apr, 02. 1999
<br />Bonded by NFNU
<br />800-224-6368
<br />
<br />oJ
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