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<br />CONDITIONS OF P&RMIT AFFZOAVJT
<br />A.. N01'ICI OF nEED RSt ~IcrIOHS
<br />fill underalgaed undIrlt1D4t lJIat till. ...nit. aa, be .ubJed to .aee.J uatric:.t10111w IIlUdllllr ba lOCI flltrlcU.. tbIn tit)'
<br />regalaUanl. Ibl UIder'i_ illURS u8pG118ibllHy (01' C8PUance -Ith ilDJ' ,ppUcallll dnd rutdcUou.
<br />
<br />, B. 'UKLICEHSBD CONTRAc~ons AND CONTRACTOR RESPONSI8XLXTIES
<br />II tile OIII8r IIu Illred a a!ntraclor or Cont.l'Ictoll to Ulldectal, worl, tiler IaJ be nquimJ lD DI u.c..s 11 ~ uti>>
<br />atal.8 and local re9lllaUona. If Ule eontractor I. not UcenBed a8 rllCjuh.a b1 law, IIotlt lIII __ _ amtnatar ., ..
<br />cited for I .Ildue.anor violatlon under statl! 111I. If lbe OlIn" or jntlGde4 coat[iCtor arl lIDCIttAlD u to *t I1C11111ag
<br />requ.1rlmlllu tal apply (or the Intellded llUrk, th@l' an advJaed to c:onucl tlls tit, of Ilpb1[hlll1 aall.Jag ~t, (81.1)
<br />788-6611.
<br />
<br />furtllarlOfl. jf till GIInu hie IIheel i C'UIlbac:lol' or CtIDtl'iCtorl, lie 18 ad'llect to ba.. tile CVlltllCtOr('J alp potu. af till
<br />'ClmtrKtor SectiUDI1 of W. aPJlUCiUon for Ifbicb i.hr -Ill be l8l(lClft8ible. If 101I, II tba __ &lp u UaI ....t.lKtDr,
<br />YOIl .1 101Uc:aUI)!1 tbat fOil, nther tfaaq tbe contractor, in respou,Jble for UIa 101'1. II till CCIatlIduc 111IIII ,. to alII
<br />u caotrac:tor that 111 be aD lndl~tion tbat. he 1& not properly llC1D1ed and JI not enUt11d to PIBlttJDg pr1'JlIgu iD till
<br />City of Zepbycbllls.
<br />
<br />c. 'l'RANSPORTATIOH IMPACT FEES AND U'.l'ILITY CON.NBCTION FEES {I
<br />
<br />D. COtfSTRUCTIOH LZEK [,ftW (CllAPTER 713, FLORIDA S7.'ATUTBS" AS AItDIDBD)
<br />I cutiCrlhet I, tM 1W11ttnt., ltaVl belli prodded lilla I copy of .FIOrida'B CooItrucUu lJa &.III . ~.r'. 'mtlCt.IoI
<br />'lIid.w prepued br tile Florida Pepa(tJlllt of AgdclIllun find CoRBUI8r Affairs. If tliIappllcat Ja ...... DtIIIr tbu tbe
<br />'OImer'. 1 cerUfJ tbat 1 be" obl.iined a COPI of the allove claacrlbec1 dualIent 1A4 pc~18' 111 gllDll faltla to Whir It to till
<br />'~et' pciCJt to ~cuent.
<br />
<br />E. CONTUC'l'OR' S/OWNER' S AFFIDAVI-!
<br />I eectlf, tlat 111 tile 1IfGaltion in Uai. application I' ICCllllte IDCl that III "oIl wIll be be 111 allpl1uca dtJa III
<br />eppUc:able II" rsgullUog c:aDluuctiou, 1000lof, iDI1land iII''/-OpltDt.
<br />
<br />App,11caUOIl 11 belU' IIda to obtain, perlit to do IOrt and wtahatioD u 1a4lcate4. 1 ClrWr tblt II) worl elf
<br />iDatalli1Uoo bu ~ prior to 188uancI of a per.it and tlIat 111 IIOrk .111 .. perlo_ to ieet at.1In1a af 111 1aa
<br />reguJaUnq COAItMUGI, CUr codu, lUning rl9daUOOI. and land d8v81op1ent rliUlaUGDlll .. jK1dcUaa. I lito
<br />certify tIIat I u'.lIItand Uaat Uae regulaUOllI of aUler gO'8l111eAtll apocJu uy appll to tile Jatlll1llllarl, IIIIJ tw: It ..
<br />.'/ [88poalibUJtr to idenUfv Ihlt iCUOI1I 1 1U1t. tale LQ be in QlIpUiDC8. Such igenclll bel_ kt an IID\ 1ll1t1lJ ta:
<br />t Departleot of En,iconlental R@Qolatlon - C~prll8 B.'/h...., Wetland Areal and 1p'lrODleDtall,'l8DIltl'. LIDda,
<br />Witer/Mlltelater freltltnt
<br />t Sovtbnat Flodda rater llanl'lIIeI1t DI8trict - lIeUI, C,prell 8a,/~. lIeUaDG Arlil, AltarlDS lIaterCDllr_
<br />I Any ~ of ~lnl'n - SebIU" 1lOcU, lavigable lfatlENI.
<br />· PIlwr~t ill R..U:h , RIlllabJllt.tbe 8enic88. IQYlroMelltal Uealtll Unit - hIla, WasteAtIt rnataeAt, Beptic r....
<br />I US EIId~t.J PratteUCII 1geDO . A8J1e.etGI abatllldt
<br />1 dao cert1fr tblt, if CUI Nt.riaJ Ie to ... lI,eel in 'Jaod Iofte -I- 01' ....tc. w, It fa WuitM tIIIt I drliDIgI pllD
<br />Iddru8Jng I .~,.tJDg lOlllol8- wHI be 8Ub1itte4 -bJcII i. prepared br . pl'olua1C1D11 qlDIIr regJIl8tlilla tIIIltltI of
<br />Florida ~rior to parait. .,Buance.
<br />
<br />. I pmit lIIued 1Ila11 be CODItrued to lie I li~eQl8 to prorMl witb.the .wk al4 Ilat ullltJ>>r1tl to 'Iolltl, caal altar, or
<br />att ..Ide IIlJ pmllilllll of tbe tecbnlcll catle8, nor lball 18!JII~ce of a perait prlVlDt tM Iulldlag OUlcII1 Il'CII tMnIftar
<br />requiIlng . correction of euars in plana, cllAstrocUoo, or wiolatiou Df aDl cvde. .,., PIEIlt iIIUIlllall ...... ""14
<br />weal tllA ~[1 lutllorllld b1 auda peclIt it ~nced lith In III mntbB of illlllllee, Gl' U ., atJubIIJ la, tJII JItIlt !a
<br />&uspen\1ed DC IbaDGoIIId for a perloc1 of ail aoatha IInu tile u. the IOIt Is -~~i. ODe gO tIr lltudma If till, III bI
<br />allOllod for t1. pua1t .ltJl tee charge of I1S.00. tbe ut.eulllon all be rtC)uut.e4 iD -dtbg lo tile Ioan"'lag Offldll. Ia
<br />Ippl'OnJd i~tJoo lUSt be lCl99ed 4udlll IlIch .i. _t.b pedod, or tile proJlI!l IfUI III CGIlUaent ~""""II".
<br />IiAIIJIJ' to !MIIII: \'OUR rAIWRI TO IlICIIID A 'OI'lCi Of' COMMDCiIIUf JIlT WOLf 11 YOUa '.'D; IIIIClIIJIIIII'IlGVDIlm to IU
<br />t'amy. 11 1QI UlIID to OBIAIJ1 FlIlAKCllIG, COIISULT "UlllWR LlIDII OJ AX AnORlIY IUDllIIOIIDJIQ YO IOIla 0'
<br />aJilDCDERt. Jaa& UlDiII 12,500 III VAJ,UK 00 lor IIUD TO RBCORD IHD POSt A w.olla OF CCIVIIICDIIIrI..
<br />
<br />
<br />~6-~ eVT' ~II~ J.~ ~~\<\.t
<br />
<br />: J:
<br />
<br />
<br />stAtl UP PLOl~
<br />aum or L .J:L.1L
<br />Tbe fOl'egolog 1n.truaeat waa a~gwledged
<br />before - . thi~ ~ ( 5 . 199'7 bJ'
<br />
<br />1'-. K~iir~ ~,s
<br />wbo 18 er oDal-!l__,__~___ 'to __~"""'\oZ' who baa
<br />produce
<br />as idea ificaUon aDd WIlD did@14 Dot') -
<br />take tb.,
<br />
<br />(Ii... Typed, Printed or StUlpeel)
<br />NorMY PU8L~
<br />
<br />N_ Typed, Printed 01' .
<br />ROTARY PUBLIC
<br />
<br />'I' LAURIE JEANNE GUY
<br />SID 01 FIoIIda
<br />UVCanm. ~_22.1_
<br />ComnI. . CC 4Im04
<br />o PERSONALLYICNOWNIY..
<br />o PRODUCED 1.0. .
<br />
<br />'I' LAURIE JEANNE GUY
<br />SIlIII of FIaItda
<br />MrCllllla. __ 22. 1.
<br />ClInIIL . CC 4tCI704
<br />o PeR8OHAU.YlCMCMN IV"
<br />o PRODUCED IJ).
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