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<br />. COHD:tT.tOHB~'O''''~I'.JIH.ttt..\AFFIDA VIT
<br />1\. NOT.tCB O~ VS.EV RBlr1'nIC1.l().HS'('ffl\~.",'I~'''~;~ ~..~,.' .... v
<br />rhl! lIncJU.Jgnltl tldder.t8tld. t..t thJ'PlrlJt".r''''!_Jee.(fto~,'tutrJeUOnl' whleb .a, be lOre restrictive Lhan Cily
<br />fl!!JIIJdlorl'. tilt uac1ft.l~lI...dWI.u,U1tf.tor).Jl .,UIa an, IppUcabl8 deed restricUons.
<br />~ '~;',., ". ~.",.
<br />
<br />B.' UNLICEHS.EU.COM'tMCTOM AND CONt1lAt'J.'Olt JtESl'OHSIBILITIES
<br />If th. owner hit. hit... . ....tt.dot ttr'tdetttac:torl loIlllfttU1I'tIDd,thfy .'rbe'requlred to be IIcensmln accordance with
<br />Blatl and lOC:II ttg1llaUCIht,. If the toIluaelor I. nol UttMtd~.. t~b" by In, bolb the OIIIIe[ .~4 contractor Jar be
<br />cited tot. tl"*lIlMtt ftt)laUOlI tmc1tr _tatl'ld. U lht....fbl'.tdtMc1tct.c:onlrador Irl unc@[laln"IBt01that'Hc",.lng
<br />tt!guhe....... II/.ppl, tot u.e lnllnc1ec1l1Ctd, the, .tl add_ll ttml.ct lhe CUt of lephrrbU18 BuUc1lngDepa,rllent, (811)
<br />181-&&11. .' ",.... . . '.
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<br />furthl!r~t~~ if the OWDl!r hal hired a conlraclor or conlraclors, he 18 advlled Lo ha'8 the contrlctor(8) 81gn portion8 of the
<br />'conlt*:tor BetH..' of ,till' . .ppHnUm for tthlth the, "Ill bt tilpon.lble. If rou, II the OIlIer 8ign a8 lhe conf.Iaclor,
<br />you 8r~ lddle.ttng that tbU, 'tathlr thin the tanlr.clot, .r. f~.lble.tor'lhe worl. If the contraclot vI8hP.u JOG 'to 81gn
<br />18 tonlr.clor lhlt .., be In lnalcltlDd that .. I. not proplrJ,'lJtenaea and lanot entItled to per.itling prl,ilege. In the
<br />ell, ,,1 JephrtMUtI.' . .
<br />
<br />c. TItAHSPORTA't10H lMPAc'r F.EES AND UT.lL1TY CoHN6CTIOH FEES
<br />
<br />o. cOHSTRUCT10H LIEN ~W '(C"^PT~R 113~ FLORIDA.8TATUTES, AS AMENDED)
<br />I c~rtjf, that I, tbt applIcant, .." been prOfJaea ,Jth . eopf uf 'tlotJda'. Construction Lien Law - HoIeoIner'lPrOtection
<br />Culde" prf!,area b, th. 'lbtJa.lJtpattMbof.'AgrJeaUar. ....~toIII1IItr AUalrt. If tIIt.pptlcant I. 100I!Ode other lhan the
<br />"owner', I certif, lhllt ) Ita,. obt.lned . topt Dr lilt .bote ,..etlbtc1 dotuIent and protbtfln good faith to del her H to the
<br />"owner' ptlor tit ~n_nt. ./0':; ... ,.
<br />
<br />E. COHTJtACTOR'B/OWN.ER'8 AFF1DAVIT
<br />I certff, lhat III the intorJltlon In t... .,pllcatlon I. accUrate Ind lhat all worl wIll be done In cOIpllance wllh all
<br />appHtabll1 I... uguJaUng c:antlntU.,'.anlllf, .8IIc11anc1;....I...t.
<br />Ilpplledlon J. ,",relt, .. ld,.tll.. ,.r.l~ t..~do IOrl,~~a"'~Ultlon ~. Indlc~tec1. . I c~rtUr that. 110 ~orl .or .
<br />Indall.tlon hI' t~\'d6tt,t't~.t~'Pltll'~tW~.l~i~rttdU ~.ptr,fo~,~ ...t .tualr~fof -WIllI
<br />r"!Jlllall", conltrutUon; CUt ~.~.~J"~I~a.t1.~CJill'.i .1~;t~ relt1'U...ltftr~)U~"dlcUOlt:J~ 1"la I II)'
<br />cerlU1lhet . "'r.t. lMt'lht t...U....bt'bl..t"tiiftlMAt.f"_l.....,.."I'.toil..'1lntemlec1 wort, and lhal It is
<br />If rl!8pottllhHUf lit IdfftUf, wi' .tU_;lt..t~W.~l" .~I.~_Ulnc8. Such ..enc188 Include but Ire,not 11.1ted Lo:
<br />. Dep.rt_t ot IDtJr.-atal llgul.Uaa Oi t,.""1 tltWHt. ..taM! At... lIIII1 Rntlronilent.allr Sen81the Land8,
<br />. ,;,. ',';;' !':l~ ,. ,'J:..bt,...tll.ltt ."...t
<br />. Southwell Floria. "It It ",=t'UIUtlct .i' ".U.,"'ty;tItlI..,Maa.,. Wetllnd. Areal, Altedng Ifatercour. Bel '
<br />· At Corpa of I8fl..... ~'~, ,.l......l~'~'.~I. ".ttttA . , .
<br />· Dep.rtlerlt 0 '. D1Ul ,"lItt cd' ",U_ . ltallh ball - VeUI. Ifalttwater 'reallent, 'SepUc lanll
<br />· US ladr-.t')"ID it~" , ".,....~...t....~;> I .'
<br />J allo cert f, t, IIttr.. I. (0 be bltd'ld .I~ toft, 'A' br 'A,ttc.', It II underslood lh3t'lldral~e plan
<br />addres81", . ltoIpf!nl.U...toJ"~;'ttUJ be .ablllJU1c11 ~"JdI,Ja ,r.pared br a profe811onll engIneer regl8tered In the State of
<br />Florida prior tet ~etlU.I"UMee. . ~,,' ". .. ,'.
<br />. "pel.ll IBlued .hall hf tdltittwc1'tirlit"~.ltteti8, to ~ttH:t'tfiUh the woll Ind nol a. authorltr to 'Iolate, . cancel aUer, or
<br />Bl!t asld. .n, protl.loM .,1 tM,~~,~lIOfa~U:~' of . pet.1t prlfent. the Building Off~c:lll frell tbereafter
<br />relJ'lldng. torttc!Uod ,I .ttOt..'iit.'....ttlHllArett hol.Uont of' Ih,tcMJlI. ,'my~ltfrtlJt.,l.IU8I1~...U.COII.I"'aJJd
<br />vnles. lhl hr. IUtflorbtd br...lpt~~J.~~:~J~...~JI .~~ of ",...ance, or.lf lIor1 luthorl.ed bJ the per.1t iI
<br />8uBpemJed ur lbinc10ned tor .ptdud ofi.l.~_[IiI~tl.tlrr.lIlUilA~U.itfOtl~j."~nttc1. One 90 dar e.ten810n of Ule, la' be
<br />allowed for the ftrtll'.lth 'II ehi.t9l:~r~.J$~II~;~~1......11 te reque.lea In writing to Ube Building OffIcial. An
<br />erpro,ed In.pedloa IUIt' btJOftItt1atttlng,tanMtI'",..i'.U. project will be con.Jdered abandoned. .
<br />""RIUle to OIIUJI! rout ,alt.. toillt'OllD,i A~lOtltr~ _ .ltAy IIlsut.r .11 YOUR PATIII' nla FOR JII'ROVIHIiIlTS '0 tOUR
<br />PROPlm. n.tcj'ldUIJ'IfJ... .m!f!-. .rc. IIiIDIR OR AI AnoRlfl' 81FORI JllCORDllfG YOUR IIorl~,OP .~.
<br />tMlUtlJlUf. " JoIt....i.'i.:.li4'~:,~ ~'..'~;i.h' ,.;\V,.- POSt A tllIOtlCl OF CdllllCIIII"". ".
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<br />BiGllnrURI: unIt OR AGlllt'
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<br />8JGIIAtURR: CONtRACTOR
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<br />STAfI 0' FLORIDA ' ~ '0 :' frAt' U, MIUA
<br />(oo""OP , .' \, 0Mm OF
<br />The tort!90inq in.t~t;.,M~I~~knO"l,.dv!~.,~;'rh.. foregoing instrument was ackn01dedg~~
<br />before Me thib . "; 'IJ~~ ,.by,. ., o.ItClforA "0 tlltR , 19 by
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<br />who is perRona11y known to 110 or WhD has. who Is personally known to me or who has
<br />produced .". f " l,lT")U:Oduced . . . .
<br />dS IdlmHflcdt:lolt end tfho Cild/dldnut. '0.'11" ldetlUfication and who did/did not
<br />take dn odUt. ",,'. . " .: I .\.'. .~..~ ,'. .; :.,~:~~kll att oQth.
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<br />(Signature)
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<br />(Signature)
<br />(Harne Typed, Prittt.ed"or st~.~~).._...
<br />NOTARY PUSl.IC
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<br />..... (Nue Typed, Printed or Stamped)
<br />· ' ,~ 'J01AR! . PUBLIC
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