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<br />A.
<br />the ....
<br />rlfUl.U..
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<br />CONDITIONS OF PBRMIT AFFIDAVIT
<br />F CTI
<br />t . perl I., labJect to ~d.ed r,.trlctlonl' Ibleb II' be IOte re.trlctl,. than elt,
<br />lilt ....,11I1.1 ...... rhpUIIIlblUt, tor cotpUIIlCI 11th aDf .ppUClbh c1lea rntrlcUOftI.
<br />
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<br />FurlhlrlDrl, If tbt owner baa hired a contr.ctor or contractor., he II advised to have the contractor(l) Ilgn portion. of lb,
<br />'Contr.cloe lectlaal' of tbll .,pllcetlon for .bleb the, 1111 be rllpoDllble. If JOU, II tb, owner sign II the contractor,
<br />rau Ir. l"'leatlllf tblt JOU, rlthlr than the contractor, Ire rllponllble for tb. wor.. If tile coatrlctor .lthu rou to tip
<br />I' .tr.etor tIIIt II, III ... Inc1lcIUon tblt be Ie not proplrl, lIcenled Ind II not entitled to perlJttlng pr..11.... In tile
<br />tit, of I~III..
<br />
<br />c. TIU\tfSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. TR T 0 L (CHAPTER 713, FLORIDA STATUTBSr AS AMBNDBD)
<br />I cert, , ." cant, f' prodded .lth I copy of 'rlorldl'l Conltruction Lltn Ln . lDealmer'l Protecllon
<br />Guide' "replr" br till 'lodet Dtpartllnt of Agriculture Ind Cona.r Aff,ln. If the Ippllcant I' .0R0ftI ot"r thin the
<br />'owner', I certl', tblt I be" obtained a cop, of the lbo,. ae'crlbe~ docuItnt and prOlI.1 In gooa f.ith to 4ell'l[ It to tbe
<br />'own.r' prior to ~t. '
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<br />E. CO~'S AFFIDAVIT
<br />I cutU, tilt i1f1&IIiilOiii8un "tbll .ppUeetlon II accurate an4 thlt III lork 11111 be 40ne In cDlpUance wltb IU
<br />Ippllcabll 1... nguJltlng c:onatructlon, IlIIIln" an4 1anc1 d.,eloplent.
<br />
<br />Application I. hlrebr l14e to obteln I plr.lt to do wor. .nd Inltallation .8 Indicated. I certlf, that no IOrk or
<br />Inltlllltlon ... CDIIIftcaa prior to 1"Dance of . perllt ana thlt all work will be perfotIBd to "It ttanG.r4. of .11 la..
<br />regulating CDnItructlon, eltr code., lonlng regal,tlonl, Ind land ae'elopaent regalltlon. In the ,urI141ctlon. I 11.0
<br />tertlf, tblt I unc1tr.tana tbet the regulations of otber go'trDIent.l Igenclee la, Ippl, to the Intendec1 worl, ana tbet It I,
<br />., rllponllbllltr to 14lfttlfr whit Ictlon. I IUlt takl to be In coepJllnce. Bueb egencl., Includ, bat Irl not lllltea tor
<br />. DePtrtllnt of In'l~l Reaulatlon - C,pres8 Barbead., Wetland Are.e and In.lrORllntall, 8en1lti" Lanai,
<br />IIter/la.tewet.t Ir.etient
<br />I - - l 1 II DI 1 - IleUe, CypruI IIJb1l148, letlllnd Arlllll, IIlt.rlng W.tercour...
<br />. ........ I, Doc , Iltiglble laterve,.
<br />. , 8mlc:u IDdr tll R ltb Unit - W,UI, WI.ttuter 'r..tleDt, 8epUc !an'.
<br />t WIlY lOt ,t_t
<br />I I .0 ctI r, . er tl II to be _ In rlood lone tlAW or IfA,lte.., It II underetoad tlllt . drelMge ,lID
<br />.d'fIIIl., . 'oalllllltlDf tOl.... 1111 be .IbIJtttd .bleb II prepared b, I prof...JooIJ tntlnltr regllterec1 In tbe ,tit. of
<br />Floria. prior to pmlt IlftIIIct.
<br />
<br />A petitt II"ed ebtlJ be con.trued to be I llcen.. to proceed 11th tbe IOrl and not I' luthorltr to ,Iolete, clDCII lIter, or
<br />aet ,.Ide anI protlllODl of the technical codel, not ehlJI f..uancI of I per.lt "r'fent the BuildIng Official fral thereafter
<br />requiring I correction of trrort In pllnl, COftltructlon, or ,lol.tlone of Inl code, I,.r, ,.rllt I,"ed ,ball becaIe In,al14
<br />unl... tbe IIOr. latborllec1 br lueh petllt II COll8llced Ilthln III IOOtbl of IlluMce, or if IOri authoriled bl the perllt II
<br />.uepended or IbIlll1aDd for I perJCK1 of ,b aonUtI Iltlr tbe tin the worl 11 ~cec1. OIle to <<If tltenslon of U_, II, be
<br />,11011" for th plnlt with tea charge of t15.00. !hl e.tenlloR ,han be requ8Itec1 In wrlUng to the IuUdln, Offlclll. An
<br />.ppro'" In.pectlon IUIt be 1000ta during each .Ix IOntb period, or the proJlct "III be eonald.rld Iblnc1oned.
<br />IIARJlI"G TO 0lfIIR: YOUR rllLURI 10 RlCORO " IOIICI 01' CCIlMIltlllllr MAY RRSUn IN YOUR PAIlIfG nllCI I'OR IHPROVlIlIn. fa YOUR
<br />PROPIRTY. JI' YOU 111110 10 011111 rIIDtlllG, COlfSDL! IIrK YOUR "IIDIR OR All A'IORIfIf BltoRI RICORDllfG YOUR JOIICI or
<br />CCJIIIICIIIICI. _ UIDIR 12,500 III VAtul DO ROI RIID 10 RBCORD AJfD POST A "MOIICI OF COMHIICIHIJIT!I.
<br />
<br />UGIA!URI: OIIIlIR 01 .'"
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<br />61~~?
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<br />who i. perlODlll, known to lie or who has
<br />produced
<br />18 identilTclt!on and who did/dId not
<br />take an oath.
<br />
<br />(SIgnature)
<br />
<br />(H..e Typed, Printed or 8t~8d)
<br />NOTAIIY ppLIC
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<br />
<br />nAn or FLORIDA p
<br />coum or A'5Q.D
<br />The foregofn; inltrument waa acknowledged
<br />before me thb 3 (<.0. ~AN. , 1'~ hI'
<br />
<br />L,NDA STILES,
<br />who 18 personally known to lie or who HS
<br />produced
<br />as iden cat on and who d Dot
<br />t Jl 0 th
<br />
<br />SIAn or Mill
<br />coom or
<br />The forego!nv Inlt~8dt wa. acknowledged
<br />before .. this , 19_ by
<br />
<br />~1"Cf,
<br />C) -=
<br />z n
<br />
<br />K IE LV WOLfF
<br />Notary Public, State of Florida
<br />My comm. expires Jan. 31, 1998
<br />Comm. No. CC338778
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