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<br />FEB-22-'96 THU 08:35 ID:
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<br />!:fOll P02
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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DBBD RESTRICTIONS
<br />'rba undenllllld IUldefltaodl tIIIt till, Plnit H' be lubJectto "deed restriction." ...Ida .," .lnatdcUfltIIaIltity
<br />r'91llltIOlll. Ih under.ignec1 UI_ rtlPQllllbJlJt, for co.pUuce rUIl any tppUeable W rettdctl_.
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<br />B. UHLICBN'SBD COaTRA~TORS .lUlL COHT:tACTC'ft ::u.~PONSI8ILITIBp
<br />If tJJt IMIe: 'Iu 1I~~ld ; COIltrlctor or'Ctll;;rllcto..:,. ~,) UII~~ttale wor::, thty II' b.i rlCJuind to be IC8RC1ID .,.~ "I~
<br />Itate IIId leal ~'!1UlatiCl1l. If tbt cootnctor 19 r;"t UcenaN II rllQU1rld bJ In, both till OIIIV ID4 LUlUICtAl' ., be
<br />:ited fot . Ilett_anor ,iohtlon 1I~~'!r Ita~ In. If tilt owner or intended eontractor an UIlCUtaia u to (~t llC1111119
<br />requireJl!llU ., appl, for t1Je intended IOrt, they Irl adYi..d to contact tAe eit, of lepbnllll. 111141.. ~t, (813)
<br />788-6611.
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<br />t'urtbenon, If tile owner baa bind a contractor or contractor., be i. .c1vi.e4 to bate tile coatnct.or(.) .lp portl.of tM
<br />'Contr.ctor 8ecUOIlI' of thi. appllcatlon for "bicll tbt, ,,111 he rupon,ibll. If roa, u tile MU lip u t:IIe COIltnctor,
<br />you are ln4!caUng that JOU, rltber tJlan the contractor, an rllponalblt for the worl. If tile CG\tiactor "hila JOlI to alp
<br />u ecmtraetor tIlat II, be III ID4icaUoa that be 11 not properlp UClDJed and II DOt entitled to peraltUag prll11.. lD tile
<br />eltr of l~ll1..
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<br />C. TRANSPOMTATIO~ IMPACT FEES AND UTILITY CONNECTION FEKS
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<br />D. CO!TRUCT!9N LI'EN LAW (CHAPTER 713, ,FLORIDA STATUTES, AS AHBlO)BD)
<br />I certJfi t I, the ."Ucant, h." been prodded wftll a copy of 'Plorlda'e CooItrvctloa Lill ... . ........'.'hotlCtloa
<br />Guide' preparec1 by the Plorld. D8pertftnt of Agriculture and Collllller Affalrl. If the Ippllcut I...... otJaer.tMIl U.
<br />'oner', 1 eutU, tht I haVt obtained I CGpf of the above dl!lCrlbed docUleDt aDc1 proml8 111 ~ faltlt to WIler It to u.
<br />' 'ower' prior to ~l88IIt.
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<br />E. CONTRACTOR' a/OWNER'S Af'FIDAVIT
<br />I eertifr tAat an tilt inforllUon in tIli, .pplication i. accurlte and tllat III IOrl "Ill be _fn CGIIpl1l11C1 ,,1~ III
<br />. appUc:abI. 1_ regulating conttructlon, lonlug, and land d..dOlll8tlt.
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<br />App!icatiOll i. bereb, lid. to obtain a perlU to do IOrl anf Jn8teUatioa II Indicated. I cerUf, tilt DO varl or
<br />luWlBtllll bit ~c:ec1 pdor to la.uance of II penJt aneJ'tlNit all worl .ill be perfOl1llll to _t ItIadudI of all 1aI
<br />rlgulatlng construction, Cit, codu, lonlng regulltlon., II1d ,111I4 de'elop.eot reguJaUont in. tIaI jurllGlcUaa. J alto
<br />cutlff that I ~It.tand that tile rB9\JlaUOIlI of oth.r goyetDlentallgenclll II' Ippl, to tbe lDtInW work, IDl1 ~t It I.
<br />IIJ rllpoulbUltr to identify "bat actions I IUlt take to be In COIpliance. 8ueb ageneh"~ ,,,elude bat Ire DOt IUltec1 to:
<br />· DelJlrtlent of Invlronaental Rl!!JUlltlon .. Cypress _,bead., lfeUMd Area. and rnfil'OOlllluuJr 81D1iU" LIDdI,
<br />"terllutnlter frettJlent
<br />· SoutJNat 'lorJda liter Ifana~t DI.trlct - ..111, Cypr... Baraa4., retland ina., Ilttriag Wltt.reOa1'le8
<br />t g CotDI of IDolneen .. .....U., Docb, 'lflglble rlttna,.
<br />t De~t of Bulth . lehlbllluthe Services, IDvlrOl\ltlltal Realtb Unit .. VeUI, lIutMter frea_t, Sflltlc rub
<br />t us Iq'lnaleatll l'rotecUoa aveacJ .. ..butOl abataent I
<br />I l1so cartlf, that, if fill ..terl.1 II to be u.ecl In '1004 loae 'A' or 'A,etc.', it f. ander.t004 that a draiDlot pllD
<br />1tJdrt81IDf a 'IllIIpeDIaUn9 JOllII' .111 be Iublitt.d "bleb 11 prepared by I prof..looll englaeer fI9Jlterec11D tile .tate of
<br />'Iorlda prior to pel'l1t i..uanee,
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<br />A penlt "IUed sbaU be construed to be a He.nl. to proceed .Uh tlI1 tIOrl and not I' autJloritr to 'lol.te, CUOIJ alter, or
<br />.et Iside an, prOYII1OD1 of the technical cod.., nor IlIa11 illuMce of I penft prevent the BuU4lDg Offlelal frGI tIlenafter
<br />requJring I C01TlCtioa of error. ill plll18, COIlItruCtion, or violatiOlll of IDp code. r,UJ penlt Jnued 11II11 ..... mattt1
<br />unleal tile vork autlJorllld b, .ucll peralt i. C088nced IffWn .il IOnthe of ia.uance, or if IOrt lutborhld bt till penjt t.
<br />luaplDded or lbeDdoaed for I period of Iii .,ntha .fter tbe U. the IOrt I, ~cecl. One 90 day at_l111 of tile, ., be
<br />allond for tile pettit lith fe. cIlarg8 of .15.00. rbt ..ten.ion .blll be requuted in writing to tbe8Ull41nv Offlcl.l. AD
<br />approved llIIPtctJon IUIt be Joggla daring IIcli .11 IOJltb perJoc1, or tin! project will be CODIlhrlG UIabtlJ.
<br />UIIC ro CMIR: YOOR FAILURI ro RICORD A IOffe! OF c~ MAY RlBULI IN YOOR PlnlG !ilIa Nt DIPIlOIIIIIh'.1O JOUR
<br />nu IIIU IIl!IIID 10. 081111 11_1 COISULf. 1f1711 YOVR J, U JnORm BI1ORIIIICORDJIG 10UI anI OF
<br />· - - '1, 00 U IIUf filii) 10 IIIaJIID 'IOrICl DI' ~. '/
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<br />IIWIURI: ... 01 AGIIII
<br />
<br />
<br />stiR or rLOIlDI
<br />coum OF #7 LL ~ f:f;ICfJU c9tA
<br />The foregoiDg iDltruaent wae acknOWledged
<br />before - tbie rC36. ~, 19~ by
<br />
<br />bA:Vib JOHrJScJAJ
<br />.bo 1e p.r,oucally MOtnl to lie e;.r WilU hee
<br />p.looncl4
<br />as identification an4
<br />..... tb
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<br />
<br />
<br />stIR 01 PLOII~ .
<br />axnm 0' LL_S r.JL>/6eJu .01 '
<br />The forego og j08tru.8IIt ... aclmOlfledged
<br />befor4 .e tbia ~. d-~, l' 2~ ,bJ
<br />, LJttJ!0 , CJ{) t(lJ ;;';(J]J
<br />who 1. verlOllaUy Mown to .. Dr
<br />~rOduC8d Do
<br />as identificatton aDd who
<br />In oath.
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