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<br />CONDITIONS OF PERMIT AFFIDAVIT .
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be Wldersigned understaDda that this penit laY be lubject to ldeed restrictions I Idlich laY be .ore restrictive tbiA City
<br />regulations. the underligned assU188 respooaihility for COIpllance lith IDY applicable deed restrictiooa.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertiU IIOrt, they lilY be required to be licensed in iCCOrdiDce "ith
<br />state and local regulations. If the cootractor is not licensed as rlljuired by 1., botb the ower aDd CODtracW lir !Ie
<br />cited for a lisdeaeanor violatioo under state law. If the ower or intended coatractor are uncertain as to .t l1CM1ing
<br />reguirel8Dts laY apply for the intended .ork, they are advised to cootact the Citr of IepllyrJailla IuildiDg DepirtBt, (8U)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas hired a contractor or cootractors, be is advised to have tile CODtractor(l) I1p portiou of the
<br />lContractor Sections' of this applicatioo for Idlich tlley ,ill be responsible. If JOU, as the tIIDIr I1p as the CODtriCtor,
<br />you are indicating that JOU, rather than the contractor, are responsible for the 1IOIt. If the CODtractor liIbea JCIU to lign
<br />as cootractor that laY be ID indicatiOD that be is not properly liC8D8ed aDd is DOt entiUed to pera1ttiDg prilllegea ill the
<br />City of Zepbyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES I
<br />
<br />D. CONSTRUCTION LIEN oLAW (CHAPTER 713, FLORIDA STATUTES, AS AMUDED)
<br />I certify that I, the applicant, have been provided ,ith a copy of IPlorida1s Cooatruction Li. fa! - ......rl. ProtectiOll
<br />Guide' prepared by the Florida Departlent of Agriculture and Cooau.r lffain. If the applicant il _ other tbiD the
<br />'owner', I certify that I have obtained a copy of tile above c1eacribed doc:UIIIlt aDd prOIiIe 111 good faith to deliver it to the
<br />lownerl prior to couenceaent.
<br />
<br />E. CONTRACTORISjOWNERIS AFFIDAVIT · .
<br />I certify that all the wonatiOD in this applicatilll is accurate aDd that all at ,ill lie daae in co.pli'IICt litb ill
<br />. applicable laws regulating conaUuctiOD, lOlling, and land develOpllllt.
<br />
<br />Application is hereby lade to obtain a penit to do work and inaWlatioo as indicated. I certify that DO IOrt or
<br />installatiOD bas C08eDced prior to iaauaDce of a peott and that illlOrk ,ill lie perforaed to _t .tIDdarda of all 1Da
<br />regulating construction, City coclea, lOlling regulations, and laDd dev810pllDt regu1atiODl in tJae juriadicti.. I alIo
<br />certify that I Wlderltand that the regulationa of other got_tal aglDCiu lar apply to tJae'inteDdecJ IIOrk, and u.at it il
<br />IY responsibility to identify what actions I IUIt taU to be ill c:o.pliance. SueIl agencies Include but ue DOt liaited to:
<br />t DeparlMnt of EnvirOllleDtal RegulatiOD - Cypr881 lIIybeadl, IlleUand Areas and IDvlrOlll8lltally S8D8itive Landa,
<br />. alater/lfaBtelater !real:lent
<br />t Southwest Florida alater Hanageaent District - Ife1ll, Cypr881 Baybeadl, MeUand Areas, Altering IYtercouraea
<br />t ArlY Corps of Engineers - Seawalls, Docks, lavigable MatlIla,.
<br />t Deparuent of Healtb i Rehabilitative Senicea, IDviroDleDtal Health Unit - Ifella, llasteliter Irea_t, Septic I_
<br />t US EnvirODlental Protection Agency - Ishestoa abatuent
<br />I also certify that, if fill laterial is to be uaed ill Flood lODe III or II,ete. I, it iI UDder.toad that a drainage pllD
<br />addresaillg a Icoapensating VOIUlleI will be subl.itted Idlich I. prepared by a profesaiODal engineer registered iD tba State of
<br />Florid~ prior to perlit. iasuaace.
<br />
<br />. I perlit issued shall be construed to be a license to proceed ,ith tb8 IOrk and DOt as authority to dolata, c:aace1 alter, or
<br />set aside any provisioDl of the tecbnical coclea, nor shall iaauiDee of a perait prevent tb8 Bu1ldiDg Official fa thereafter
<br />requiring a correction of errors in plana, CODItructiOD, or iiolatiooa of IDY code. bur pealit 1uued Iba11 beCXII8 iDlalid
<br />unless the work autboriled by such penit is co.enced ,ithiD Iii _till of iaauanc:e, or If IOrt autboriJed by the perait is
<br />suspended or abandODed for a period of sil _thI after the tile the IOrk is cc.enced. QIe 90 day uteuiaD of tUe, -J be
<br />allowed Jor the penit with fee charge of .15.00. lbe at_I. IbI1II1e requested in IIl'IUng to tJae Bu1ldiDg Offic1i.l. III
<br />approved inspection lust be logged during each au IODth period, or tb8 project ,ill be COJIlidered iNOOonN.
<br />alARNIHG JO OaIBER: YOUR FAIWRI 10 RECORD A IOrICl OF ~ lilY RBSULI II YOUI PIYIIG !IIICI POI IMPIIOVIIfII!S 10 YOUi
<br />. PROP~'1 I~,YOU. EHD 10 0B'l'1lJI FlIIAIICIIG, mlSULllfI'IH YCIII J.IIIDII CI II moRIIBY IIIPOIII utOIIDlIG YQUI JIO!ICI OF
<br />ClIIIIIICIIIEII J IIIIDIIl f2.5GtI DO IIID 10 ...~,
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<br />
<br />
<br />r L 81G111. i or c;:r fr-,
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<br />
<br />BfA!. 01 PLOIID&
<br />coum OF
<br />Tbe foregoing i~t1'Ull8D~as a~ledged
<br />before me tbis ~ I , 19.:1..?- by
<br />
<br />srArK OF FLORIDA
<br />COUN!Y OF
<br />The foregoing ~t........t ..ae acknoooledged
<br />before me this IlM'(7) I{~ 19 S+- by
<br />
<br />who is personally known to 118 or wile tail&
<br />p~ceQ..
<br />as identificatioa and who di jd
<br />take an tho -
<br />
<br />
<br />who is personally known to IDe er wile us
<br />pi: .Aucecr-
<br />as identi . ation and wbo
<br />take an tb .
<br />
<br />(Signatur
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />(Millie Typed, Printed or Stilllped)
<br />NOTARY PUBLIC
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