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<br />), CONDITIONS OF PERMIT AFFIDAVIT
<br />',jiA. NOTICE OF DEED RESTRICTIONS
<br />':~~fhe undersigned understands that this peIlit lay be subject to "deed restrictions" which lay be lore restrictive than City
<br />')2regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />'::i
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<br />
<br />'~t .
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<br />~. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />:.iJ.~certify that all the inforution in this application is accurate and that all work will be done in compliance with all
<br />:'Bpplicable laws regulating construction, zoning, and land developlent.
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<br />;~pplication is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />;inStallation has cOllenced prior to issuance of a perlit and that all work will be perf oIled to Jleet standards of all laws
<br />'regulating construction, City codes, zoning regulations, and land developllent regulations in the jurisdiction. I also
<br />'.'certify that I understand that the regulations of other goveIIllental agencies .ay apply to the intended work, and that it is
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<br />'Iyresponsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to:
<br />:!:DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />~: Water/Wastewater Treatlent
<br />.~::Southwest Florida Water Hanaguent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />~sArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />'.'~DepartJent of Health << Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t::US Environlental Protection Agency - Asbestos abatement
<br />l' also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc,", it is understood that a drainage plan
<br />a4dressing a uCOlpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
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<br />Ap8l'lit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />6~t aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter
<br />r8.guiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall becOle invalid
<br />unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a periOd of six IOnths after the tile the work is cODllenced. One 90 day extension of tile, lay be
<br />allowed for the peIlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
<br />UIllG fO 01iHER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY RESUn IN YOUR PAYING TWICE FOR IHPROVEHEHTS TO YOUR
<br />P.RQPIllfY. IF YOU IJft'BllD ro OBTAIN FIHAHCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOfICE OF
<br />~CEHElll'. $2,500 IN VALUE DO NO'l NEED TO RECORD AND POST A "NOfICE OF COMMENCEMENT".
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<br />SIGNATURE: CONTRACTOR "
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<br />,..",to.;., .
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<br />STATE OF FLORIDA
<br />COUKrY OF \?~~ ~'")
<br />The foregoing instrument was acknowledged
<br />~~t()re me this ~ ~ ~ 4 I 19~ by
<br />
<br />,","';'1l~''''''
<br />
<br />STATE OF FLORIDA ~Je ~
<br />COUNTY OF
<br />The foregoing instrumeq~ was acknowledged
<br />before me this ..:~:y..::::J (j , 19~ by
<br />
<br />..,~~
<br />
<br />w~o is'~allY kn~to me or who has
<br />produced - ~
<br />as.t.".l. dentif~iOD and. who did id no.t
<br />t,~~e an oat ~ ~ ~.
<br />~, '&. ~f'<-, 1'<','>- 1'...
<br />(~~gnature)
<br />
<br />who is~~onal~o me or who has
<br />produced ....
<br />as identification and who did~dIdnoJ0
<br />take an oath~ ~ r\ \(.....
<br />~'" C\ '1 ~ r",~" t-...
<br />(Signature)
<br />
<br />.,'ill~.1
<br />
<br />, enner
<br />(!;l~t! Typed, Printed or S,t.,A!!IP~~eHKenner (Name Typed, Printed or Stamp '" M C '. CC
<br />.::::' ~ NOTARY PUBLIC * * y ommlSSlon 703125
<br />NOTARY PUBLIC :~~MY Commission CC703125 ....,......" Expires December 16,200,
<br />. .,,;~'fl.~ Expires December 16. 2001
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