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<br />COJlDITIONS OF :: 'mElT AFlI'JD.AVlT .
<br />,'~. J:tOTICE OF DEED RES'l'kICTION5,' .
<br />i~, ,;, '. aignaO \ma<ll:llt~dB that tbls penllt Aap ~e 6,ubj!Jct 1.1 "(jiJ2d restrictioos" ....ch laY bl1 ~re tGBtrlC\ivs ,than City
<br />nl:.uO;l~. no und~l:'ill!JIlBd assailS reaponslb.ilJty {or ciJ:jo'tance lIith any IIppHcal1e deed relt:ricUoaa.
<br />
<br />:'. 1pJLICENS.KD CONTRACTORS AND CON5'fi;..C'l'OR RESPONSIBILITIES
<br />:f t::. (,IWfll>f hall IIIred a contractor or COIltractor'S to un\i"rD::c: >lark, they .ay be required to 00 Ul:al186d in accordance with
<br />:L ~ ... local regulatiolls. lf the contractor 18 not liCe.1;;,:.) aD required by lall, both the mmer And contractor laY .be
<br />:Hw iOt it ll.ladtl&5iU10r ..iolllUon under state law. [f th~ c:n::,r or intended CDntractor are uncertain al 1:.0 what UC8llsing
<br />'~;L1iJUollDt.B ~3Y apl)ly for the .intended work, they are illh:iC:l'l to contact the Citl of zepbyrbll18 BuIlding Departaent, (BU)
<br />'~:-6&11.
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<br />:'urthem:>re, H the mlnQr haa hIred a contractor or contractors, he Is adviBed to ham the contractor(,) aigD portJou of the
<br />CNtractar 8octions' of thJs applicat10n for IIbicb they dB bJ responsible, If}'OU, as the OImef sign as tta contraetor,
<br />: :lU Are indicating that you, rather tbllll tho contractor, ilrc nd(X)nsible for the work. If till! conttaetoA wiBbe.8 you to sign
<br />i J ccotrilctOI tbat t:lilY b~ /1JJ lndication tbat be is not p.ru)l:rh 1icl!l13cd and is not entitled to pera1ttlng pr1VUegiB 1n the
<br />( ili of Zcpbyrl1ilIll.
<br />
<br />TRANsponTATION IMPAC~ FEES AND rfTILITY CONNECTION FEES
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<br />CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS ANSNDED)
<br />] c2rtlfy that I, l:lJe ilpplicant, have been provJded with tl copy of "P'lorIda's construction Lien Law _ HoIeoIaIer'8 Protection
<br />: Ji~~" prep.l[ed by the Florida ~partnnt of Agriculture and CQilSu:'ISr Affaire. H ths applicant is 8~ ot.bor than the
<br />'(;I':er~, I certify tbat I hllve obtained a copy of the alXlV{! LJe,;,l:ribl!d docu.ent and prOlliBe in good faitb to daUver it to t1Ie
<br />'::mer" prior to couencelPent. '. .
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<br />-. CONTRACTOR'S/OWNER'S AFFIDAVIT ,
<br />I cDrtify that all the rnfor.atlon in this application 15 accurate and that 311 wort viII bo done in COIpliance wIth all
<br />';)2icablB lClW8 regulating construction, zoning, and lalld c1p.;'alcp.i:l!JIL
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<br />:;J1.icat!on 1a hereby Eado to obtain 11 per'it to do Ifork ant'! inutaUlItion as indicated. I certify t.IIat no !tOri: or
<br />i~talJatjon has ~encQd prior to issuance of B ~it Ilat all work will be perfOrJed to lest 8~ of all lavs
<br />'!\.:lating construction, City codll9, loning reguIat"Mns, . ana developtent re.gulations in tbe judacUetlon. I also
<br />'. ii fy t.bat I understand that tbe regulations of otller gov... "mtal agencies l8y apply to tbe intenc1ed 110ft, ana tbat it fa
<br />. ranDOnaiblljty Lo identify ~hat actions I Dust take to b~ in co~plillnce. Such agencies include but ate not ll1ited to:
<br />;;i'PJrLtlent of Ellvironr.r.otlll Requlation - Cypress Bilybe.adBf Watland Jlrei,tlS and Bnfirollllelltally BenlitivlI ttlnd:s,
<br />Watar/Wastevater fr~,tEent
<br />?G:Jtht'eSt Florida !.later Hanagllllsnt District ~ WeUs, Cyprr:S(l Bayl1eadil, Iletland Areal, Altering Watercours81S
<br />. ~rJy Corps of EnqinenrB - Seaw4lla, Docks, Kavlgable Wateruaye
<br />u-:~rb:ll!Dt of Health & Rehabilitative Services, EnvirOIlZ.lent;1} .Health Unit ~ Vells, Vaatevatet TreatJlent, Septic Tanks
<br />~i-K~virGnl9ntal Protection Agency - Jsbestu8 abateceat
<br />:1'>0 c:;rtify that, if fill PaterJal is to be used in Flood LOlL1 "ij- or "A, etc. ", it in understood that a drainage plll11
<br />]T2r:,!ng J ~cOEpellslltlng volllllsM will ba 8ulmitted whiCh ill pnpaz:e(l by a professional engineer registered in the State of
<br />:: .:'::1 prior to r.en'iU, iauu/!Ilce.
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<br />)tc~it iasuod shall be cotllltrued to be a lice~e to proceed with the work and not as authority to violate, cancel alter, or
<br />: "sids any provisions of tba technical codes, nor shall l!l&u!llICe of a PQrait prevent the Bullding Offici.l fr~ tberaafter
<br />. ;u.iring a correction of errors in plans, cOllJltruction, or violations of lID}' code. Bv81'J pera1t 1B1uect lhall beCOI8 InvalI(j
<br />,;<'S the titJrk author:bcd by such PeI1lit ia oouenced within &1:.: fionths of issuance, or if work euthorbed by the pQrlit 18
<br />',p:nc~ or abandoned for a period of sil *,nthB after tha tine the work is couenced. One 90 day utenafcm of tille, .lay be
<br />: .J.oo for tho permit llith fee cli!ll'l]e of $15.00. The extenilll)n shilll bEl reque.9ted in Iftitlnq to the BulJding Official. An
<br />,fcveJ ins;(lectic);l Zlust he logged during each 81x IiQntb period, or the project will be COJIIide:rec1 abandoned.
<br />,~ ],!iG '0 mtltRR: YQiJR l'AIWRll YO RBCOfU} A MorICH OF COIDlf11CR:lli!P:r MY RESULT IK YOUR PJlYIIG !tIICB FOlllKPROVEHEllTS !O YOUR
<br />?~ f:Ti'. IF YOU lllTEJCD YO OBTAIN FIfWfCING, CONSl/Lf wun YOUn LENCiRR OR All' AnOmI BBFORE RiCORDIHG YOIm JiarIClI OF
<br />"'C/IllHT, ,oas lJlIlJ2R 12 "VALllx 00 HOT IiED'O ",emiD rum~~.,
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<br />..AI 'fllH1l: C CfOR
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<br />~ ,'LE OF FLOOlOA
<br />';'f ...., 0') /)/1 ('-fi"
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<br />"'1:. foregoing instrument was acknowledged
<br />Cr-c ,r,s this rB3f?u~,,! 1.2., 19-2.Z. by
<br />
<br />... )./ELSoJJ RVUAJ,)
<br />:'j ::.~ personally known to lIIe .or whg b:ag
<br />-. :,u;ea
<br />:,:"ulU.f.ic6l.f.c&-and who did/did 8et:
<br />
<br />:.,~ ~th. 8s
<br />;:.';!i)ntu~lj~ !)_'\.! ,_ 07:"'-'~
<br />-I< AT1--I~t21\.1 ~,~T~ ~vJ0
<br />i ,) 'l'ype<t, Pr1ntsd or Stamped)
<br />- ~,;y PUBLIC
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<br />STArE OF FLORl~_
<br />CGillifY OF IRS r" n
<br />The foregoing inatrument W8S aCknowledged
<br />hufore Il!.e this I'=t;;~~y I .?- ~ 19~ by
<br />
<br />, NEL~t)N K~'AtJ'
<br />tlho '1 ~ !,~!'~~!!!!ll}"!r.n . t~ mo -;:;:;- -;';~Q &$
<br />-i;U'6duced
<br />as 1deBtif~GatigR and who ~/d1d not
<br />taJt o. an: o~tb. ~,______/1 /1 '~' /],
<br />~~'e,---" .J. :2i eLf-. r-
<br />( S :1gIlature) '.
<br />kATHLeE,,-J ~T BRDWN
<br />(NiJIlle 1'.'i"ped, Printed or Stamped)
<br />,!!O'l'AH'l PUBLIC
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<br />KATHLEEN J BROWN
<br />My Commission CC449029
<br />Explr.. Apr, 02, 1999
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<br />KATHLEEN J BROWN
<br />My Convninion CC441lO29
<br />ElCp/ree Apr. 02.1999
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