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<br />COND I TI ON~,
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<br />f'FF I DA.~ I T
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<br />NOT I qE OF DEED RES"~ I CT I O~1iJ _~1:~-,,\"
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<br />The.undersigntd understands that this plr.it IIY bl IIbj"A \0 -dttd rtltrictionl- Mhic~..y be .orl rlltrjcti
<br />uguhtionl. Thl IIndenigntd 1I........,I....~~~~.nt.J!W!P~:.~. "U_ IllY .PPl).~!!~!~.~.~~r.icUo...
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<br />B . UNL I CENSED CONTRA~TORS' ~NQ CQ~"U'I9ft.~~SPP~i I JJ 'L-- J T J ES
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<br />If th. owner has hired a contrlctor or tontrl~\or. to und.rtlk. lI.rk, . they lay be requiTtd to be licensed in ace
<br />,tit, Ind 10cIl regulations. If the contrlctor il not 'icmlld .. rlquired by llW, both'tbl .wner lAd. etat,
<br />cited for I lisdunnor violation IIndtr .t&t. 1'11.' If ,., owner or intended contnetor Ire IIncerhin II to IIhd'
<br />requirelents lay Ipply for the intendtd lIork, thlY Ir. advistd to contact the City of ~yrhilll 8uil4i..
<br />788-6611.
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<br />Furtherlorl, if the ollner has hirtd I contractor Dr cODt!actor., he il advised to hive t_e contrlctorts) lign
<br />'Contractor Slctions" of this appliCltion for which th.y lIill be responsible. If you,,, 'he Dllner ligl.l.
<br />you Irt indicating that you, nther tban thl clntflclor,. ,..n. ,,,'''''.,It for the It.Prk............!.~~......co. ntr.it...to.r..". i.'. b..
<br />as contractor thlt ~ay be an indic.tion that he i, not P'IPIf'Y lic....4..nd il not',,,:.. "~'per.i~~if
<br />City of Zephyrhills. . . "
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<br />C. TRANSPORTATION IMPACT FEES ~~Q UTILITY CONN~CTI~ f~ES
<br />D.- €8NSTRUCTION LIEN LAW (CHAPIE;:R 713. FLORID~ STA;TUTES,
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<br />I certify that I, the Ippliclnt, have beln providtd ,,1t_ I copy of -f~orida'. Con.~tucti~n Lien Lall - HOltON
<br />Guide" preplred by the Florid. Dep.rtltnt of Agriculture Ind Coalul.r Afflirs. If'the l;pIiClnt i5 50.-1.. 0
<br />"oNner", I certify that I havl ob'il_ a copy of'~'.lI,f!~!ib,d dOCUlent and proli" in Ql'lod hUb to d
<br />"Oltner" prior to cOllencelent.''''" ,. _.
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<br />CONTRACTOR I S/OWNER I S AFFID~VJTf :'1,
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<br />I certify that all the intonation in thilapplicltioll lllC~ur"1 .nd that all work _q}be done in c",'i.
<br />Ipplicable hilS regulating construeHon, loning, __llrlftl1t."tN. .'';
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<br />Application is hereby lade to obtain a per.it to'do ..,tj'''ci..lIll~.on as indicated.. I certify t~at PI
<br />inltallltil'ln has cOllenced prior tD issuante of a p.rail and lhat all work lIill be petltr"d to leet~s'la4If. ,
<br />regulating construction, City codes, IDning regulall.II;. lId.l.nd devIlop.ent rttulltt~' in the jurisdlctiD,'
<br />certify that I understand that the regul.lionl of other ,ov.r...ntal &geneies .ay appl~~o the intended IIDr~'.
<br />.IY responsibil i ty to identify IIh.~ ae\io~s.) IUsl tlk., to bliD cOlllli1nee. Such ageneies include but al!
<br />....' __ .~~,M" ~__,_"____ -,--. ,~,~~'..-- ,,_.,:::........
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<br />I DeDartae~t of Envir~n.lmtil Reaulation . Cyprus 8.,...illlUiDtl Artll and Envi,.uljSenli.i..
<br />U.ter/Wllt_hr Trlatant" .
<br />. Southwest Florida \later "anaattent District - 1le111~.typrlll Bay_d5, Uethnd~f_AH.ring V.\~r,.<"
<br />. ' :i',~".'r-<"("':'~ ,c, ",:",~'r,
<br />I Any COrDS of EnQineers - Seallalls, Boeh, Nangabl. "deroys ' ..
<br />I De art~ent I'If Health L R~habil'h 've erv' en,.. ...... h Unit - Wel!!f',~( Trttl~
<br />t US Envlronaental protection ADeney ~ Aibntol Iba'...'" .'.^"~. ....
<br />. . . ."..''''....h'~'i. ,. :'~,;
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<br />I also .tertify that, if fill laterial is to be uled i~1014\Zoal -A' If "A,ett.", it'tl u~erstood t"~t i
<br />addr~55ing.. "COlpen5~ti~g vol.- .lIill ~, ~ub.it''''.iellF.i''~I!edbY i prof!ni~.neerr~i
<br />flOrida prior to peril t ISsuance. , . ., .~..' .I' )';,,. ....,.
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<br />A penH issued shall be construed to be I licens. to proct.td withtbe wDrk and..l> , tUrity to'
<br />set Iside Iny provisions of the technical codel, nor Ihall illUanee of a perlit prev~~tht 'uildiftg
<br />requiring a urrechon of erroTS in plln.. eonstfllctiDn, ,ot'vlollUons of an~ tQ.de.~! ,~rlit ill~r
<br />unless the Nork authorized by such penitls cOH,nttd IIlibi" six IOl\ths of luuanee,"- If work IUthDfl
<br />suspended or abandoned for a period Of Iii .o"thsafl,r1bl tilt t. hawork is tOlRn~I.'..'... r~~' 90 dlY eJt
<br />allOlled for the penit !lith fee charge of tI5.00. Th, ,dulion ~U be requlI~td~ . c' Ihlg to the
<br />approved inspection lust be logged during elch sil lOath Period, or the project lIill'~eo~idered ib~l
<br />.~'N.'" '" ,~'1\,~,".':'" ;".~i;
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<br />WARNING TO OWNER: VOUR FAILURE'TOtRJ::CORD A NOTICi~;QF'COMMEN
<br />RESULT IN VOUR PAVING TWJC~FOR ~~~pVEMENTS TO.. y,.~>....P.ROPER!V,'."
<br />INTEND TO OBTAIN' FINANCING, CONSULT WITH'VOUR~e""OR AN~.
<br />BEFORE RECORDING VOUR NOTICE OF COMMENCEMENT. ,:J ';'.UNOER $a,
<br />DO NOT NEED TO RI;:CORD ANI;) POST A '~~T I CE OF C ',T ~
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<br />-(J SIGNATURE~'.' . _:_ '~-. ___Cl. ~~. ~~-.~..- --,....~.'.-:,...'~
<br />OWNER OR AGENT~ ~ l,~lr
<br />DATE____~~~~~~------~-----4.-:~~~~~
<br />NOTARY AS TO ~."
<br />OWNER OR AGENT ..... ..... ---
<br />MY COMMISSION -XPI ~&- ~
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<br />i \ Nolay PublIc. State d FIoIlcla
<br />Mv Comm Exp. June,~ 1997
<br />No, CC 292357
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