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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undenigned Ulldlntanda tllat tIIh penit u, be eubject to 'deed restrictiClll8' lIhich u, be lOre restrictive tIIaa Cit,
<br />regulltiClll8. Ibe lIIldereigaed ...... rl8pODlibilit, for COIpliaace witll aa, applicable deecJ restrictiClll8.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tile -- .. bired a CIIItractor or contractora to IIIICIerWe IIOrt, tbey iii' be raquired to be liceued in accordiDce witll
<br />atite aad local regulatiClll8. If tile CIIItractor Ie DOt liC8llled u raquired by I., botll tile __ aad CIIItnctor ., be
<br />cited for a lledeleaDor ,iolatiOD under etite law. If tile OII08r or illtended CIIItractor are UIICIltaia u to IliIat liClll8iag
<br />requin.uta u, appI, for tile illtended IIOrt, tile, are advieed to COIItact tile City of Iep/lyrUHe IuilcUag Deparbeat, (813)
<br />788-6611.
<br />
<br />Furtllenore, if tile 0II08r .. Ured a COIItractor or CIIItracton, be ie advieed to llave tile COIItractor(a) aiga portiGua of tile
<br />'CoItrlCtor SectiClll8' of Wa applicaUOD for lIhich tile, will be responsible. If rau, u tile __ eiga u tile COIItrlCtor,
<br />rou are indicatiag tllat rau, ratber tIIan tile COIItractor, are responeible for tile IIOrt. If tile COIItractor wiallea JIIU to aiga
<br />u COIItractor tllat u, be an indicatiOD tllat lie ie DOt Properl, liceaeed and Ie DOt eatitled to penitUag pri,ileges ill tile
<br />City of Iep/Iyrbille.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify tllat I, tile applicaat, llave beea provided witll a capy of 'Florida'e ConatrucUIII Lien IaI _ .....'a Protectilll
<br />Guide' prepared by tile Florida DeparUeut of Agriculture and Coaaaer Affaira. If tile appIicaat ie --. otber tIIaa tile
<br />'-', I certify tllat I llave obtiilled a copy of tile above described cIocu.eot aacI pnlliae ill gond faitll to deliver it to tile
<br />'OIIIIlIr' prior to -q~t.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certif, tllat all tile iDforaaUIII ill tIIie applicatilll Ie accurate aacI tllat aH IIOrt will be doae ill COIpliaace witll all
<br />applicable I.. regulatiag COIIItructilll, lCIIIiag, aacI laacI de7eIO(llent.
<br />
<br />ApplicaUIII Ie IIerebr .. to obtaill a penit to do IIOrt aacI installatilll u indicated. I certif, tat DO IIDrt or
<br />iDltallatilll .. ~ prior to iuuaace of a penit aacI tllat aH IIDrt will be perfoned to ..t ataadardl of all 1_
<br />regu1atiag COIIItructilll, Cit, codea, lCIIIiog regulatiOll8, aacI laacI develO(llent regulatiClll8 iD tile jurildictilll. I also
<br />certif, tllat I UDderataad tbat tile regulatiClll8 of otber gDVerJlleDtil ageaciea u, appl, to tile iDteDded IlIIrt, IIIll tat it ia
<br />., responsibilit, to ideatif, wllat actiOll8 I I118t We to lie ill COIpliaace. SucIi aguei.. iDclude but are lilt lilitecJ to:
<br />t DepartMat of lD,irGllElltil IequlatiOll - Cypress Baybeads, lletlaacl Areas aacllDrircllllllltally Sealitive Laada,
<br />Ilater/WUtellater rreaUeut
<br />t Soutlllleat Florida !later IlaaaQHeat Diatrict - IleHa, Cypresa Baybeada, lletlaacl Areas, Alteriag Ilatercouraa
<br />t Any CorDa of Ilngiaeen - SeawaHa, /loeb, lavigable Ilaterwap
<br />t !leJan-t of 8eaitll , lellabilititive Senicea, IDvinm.ntil BeaitllllDit - llella, Ilaatewater freaUeut, Septic r_
<br />t US IDrirGllElltil Protectilll AgIIICY - Aabeatoa abat_t
<br />I allo certif, tbat, if fill uterial ia to be uaecJ ill Flood loDe 'A' or 'A, etc. " it ia undentood tbat a draiDage phil
<br />ilddreaiDg a 'CllIp8Daatiag voIlIII' will be aublitteclllllich Ie prepared by a professilllll eagiDeer regIetered iD tile State of
<br />Florida prior to penit iaUlllC8.
<br />
<br />I penit iuued IllaHIIe ClIUtrued to lie a liceaae to Proceed witll tile .t IIIll DOt u autllorit, to 'foRte, caucelllter, 01'
<br />at uide iIIIf proviaiOll8 of tile teclIIJical cocIea, OIIr lllall i8lUlllCe of a penit preveat tile BuildiDg Official fnll tllereafter
<br />reguiriDg I correctiOll of errore iD plaua, COIIItructiOll, or ,iolatiOlll of auy Cllde. IYerr penit billed allaH becme malid
<br />UIIlw tile IIOrt autborIeed by auell penit Ie cc.eac:ed wiWD ail _tile of iuuaac:e, or if IIOrt ~illllllJ tile penit ie
<br />IU8peDded or abaadoaed for a period of eil _tile after tile tile tile IIDrt Ie a.eaced. l* 9D daJ eateaei.. of u., ., lie
<br />allOllld for tile penit witll fee charge of '15.00. !be atailll allaIl be rllQUeated ill writing to tile IuHdillg Officill. Ia
<br />apprDVlll illlpectilll _t be logged duriag each eil _t11 period, or tile project will be COIIIidend abaadoaed.
<br />IlAUIIG 10 lIIIII: lID FAILlIU 10 IIClIIIl A IIOrICK OF ClIIlDCIIIUr lIAr IIISIILr II IIIlIl PIfIlG IIIICK PII IIIPD-.q 10 IlXII
<br />PIOI'Im. IF YOU IftIIlD 10 lIIrlll '11UC11G, allSULr IlIra YOUI ~ IIlftIIIIr BIPIIU IlICIIID IIIlIl DICK or
<br />aMIICIIar. JlIS lIIDII '2,500 II VALUlIlD lOr IUD 10 AID 'DI or aMIICIlur'
<br />
<br />SIGIIIIIIII: lIIII ~ IliIIIr
<br />
<br />
<br />Brill OF FLlmDl
<br />amn or
<br />The foregoing inatru.ent wa. acknowledged
<br />before lie this , 19_ by
<br />
<br />BrAII or FLlIIDI
<br />aum or
<br />The foregoing instru.ent was acknowledged
<br />before lie this , 19_ by
<br />
<br />who i. per8Clllillly known to _ or who bas
<br />produced
<br />es identification and who did/did not
<br />take lID oath.
<br />
<br />who is per_ally known to lie or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />(Nae Typed, Printed or Stllllped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />(Nue Typed, Printed or Stllllped)
<br />NOTARY PUBLIC
<br />
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