|
<br />.~----
<br />
<br />---
<br />------------
<br />
<br />,-16-1997 03:10PM
<br />
<br />LARGO
<br />
<br />1 813 530 3465
<br />
<br />P.01
<br />
<br />CONDITIO~S OF PERMIT AFFIDAVIT .
<br />^ _ r~OTICE OF DEED RltST1UCTIONS .
<br />110, ,,",<iig'" "l,,,toods lIIot till. po"!' 101' '" ..blee' '0 'Ieo<! [""I.U.... llIlIclIlOI' '" .... [.."I,U" tbn ell,
<br />re<Julat\1~l9. The undersigned assQes re.8ponsibility for tulpliance .ith any applicable..dee4 restrlctlOO8.
<br />"
<br />\
<br />E. \NLICENSED CONTMCTORS ANt) CONTlll\CTOR RESPONSIBILITIES
<br />I [ 110, - ,,'" 110, M[,,} . ""tractor o[ t<llItract." to _talo lOti. tllef 101' be ~oItei to be IIce- 1A aaxml- .ltII
<br />otat. a, Jo",1 "g.I.Uo". If till! "",tr""tot I. mit Iicen..O aB "qulre4 10, lB', will tho llOIIler aIIII t:IIIIl"~ JaY be
<br />,it,d r" . ,i&deIoa..[ .lol.tlo. ..... ota.. la.. If 110 ..... oe I.teolel contraclDr III 0R0IC,,1a II to .bat 11eenslng
<br />loquiI"'''ts "1 'PPly 10' tho loteoled "'I, !borare ol.lool to ...tact tho elt, of Z!l6Jcb1l1. 1u114\ng beplrlJllt. (811)
<br />780-661) .
<br />
<br />forti"""),,, II tho OII1Ie' 1>1. bleed' contuctot 0( ...t.""ln.., be I. adwl.ed t. bait tho CllOtUC:tot(.) ol!ll' pIlltlao8 of tbe
<br />"Contp\or SecliOflIl" or tblB appllcal10n lor whicb lbe, .111 bf ~8p<)nBlble. J[ JOU, as the Olfnef 11gn .. lJIe contractor,
<br />vo, "r ;"dl",llog lbol roo. [,tlor tloo tb. ""I[ector, '" reopOO.lbl. 10' tho IOtt, If tho c:onlIoctor ,lsIoB ;00 to .Igo
<br />as conti~ctO( thal lay be an indication tbat be i8 not properly licensed and i8 not entitled to per.lttlng prl111egel in the
<br />City of 7.ephyrhlll~.
<br />
<br />C. ';TtJ\NSPOlt'rATION IMPAC'r FEES AND UTILITY CONNECTION FEES
<br />
<br />lJ . .' yl'l S TRUD'! ON LIEN LAW (C~P'l'BR 713. FLORIDA S'l'II'l'I/'l'ES, 'lIS IIIlENnJW'
<br />1 certi i'y that I, the ,pplicant, have been prodde4 IdtlJ a copy of -Florida's can.trucUon Lien tal .. ao..ner'. Protection
<br />Cuide' ,'''1>',00 brlbl! floriO. \leper....t ollgri..ltore aoo eoo.- J(hl". nibs IfIIUcaat I, ........ otW tIJp tho
<br />.owner" [certify that I baY' Obtalped a COPf or tbe abo., de8crlbea ooeo.ent and pJOIlle in good faltb to dell'l[ It to the
<br />.000ner" pdo[ to COdenCetient.
<br />
<br />E. ':Q.N.'rnhC'rOIl~/OWNEn' S AFFIDl\VI'l'
<br />I ,e'l;!y that all tIo Inl....tl.. In !bi. ",IICltl.. II aceora.. aoO llot all wort ,III be done I. c:lfPll.... ,Ith all
<br />applit~o18 1a.8 regulating eonstrucllon, lonlng, ana land Oeyeloptent.
<br />
<br />~pplic0tionis hereby .ade to obtain a per.lt to do work and installation as indicated. 1 cartifr that no fOlk or
<br />insl31 '"lion hill COllenc:ed prior to !tallance or 8 pe[.it .nd UJat all wrk will be pedorlll1 to ."t ,taml.rl1l ~f III 1m
<br />regul" ing construction, City codes, loning [egulatlont, and land de,eloptent regulations 1ft the jurisdiction. t allo
<br />cerlil ~hat I understand that the regulations of otbtr go"roJentel agenclel Jill ,pplf to tbe Intended JOtl, ana that It I,
<br />-i reG' 0nsibillly to identify whal actions I lust take to be in co.pliance. Such agenclee include bot are not Il1lted to:
<br />I ~, laent of Knvlronlenlal Regulation - cypr,!, Bayheads, Wetland A[ees and In,lronaentally 8enaltl1e Lands,
<br />WaterfMast..ater treatlent
<br />. ~~_\~l\8l Florida llale[ HanalJennt Di8tdct - Well., Cypress 8arhe~8, velland AreUt Altering Watercourses
<br />l flu] colP!! of Sn!lineerB - Seawalls, Docks, lIadgable Walenays
<br />. ~l?': i~of Healtb , Rehabilitative Seniees, Bndr01llental Health UnIt - I,ll., lIast_ater trtatlent, Septic tanks
<br />t N-l','.lronnnlal PJot.ection Agent! - Albellol ablt.l!nt
<br />I ~l~\f c~(tl(y tbat, if fill .ate~lal i, to be used In Flood Zone .~. DC "A,etc.., it 18 understood that a dralDIQe pliD
<br />i1\jdre~ ~ ;1g a 'co~pensating volUte" will be Bublitle4 lIhicb 1& prepaled bl a professional engineer regillere4 In tM Slate of
<br />flod ;[ io( to pe,.It issuance.
<br />
<br />t per issued sball be conal[ue4 to be a license to proceed with the WDtk and Dol al autbotitJ to ,lolale, cancel alter, or
<br />"I ~' ,,', "V p,.,ialon. 01 th. lIcloi,al ,ode" .0< aloll I..~.nc:. 01 . pI"lt p"".t the ..lldlogO/fiel.1 froo tle<eBltBr
<br />requl; ~f<9 a correction of errorl in plans, construction, or dolatlons of Bnl code. 'very pM.it 1l8lled 'ball beCOlllnyaU4
<br />\!nh~s< the lIork authorhed by such perlit is ~ced .Uhln III .onths of lBw8Ilct, or if .orlntllorbed br the per. it 18
<br />r.u~pe;\]l~d or i1bandoned for a pedod of III 801\t.hB after the U.e the wrll 18 c~ncea. ona gO aI, 81il!DlJon of t.Ue, lir be
<br />1110\0 d [~r the per.it wU.b fee cbuql of $15.00. the plensIan sball be requeated in ,dUng to the BuUding Offielal. An
<br />"ppro"i\ Inspection Just be 1~e4 during each sillOl\t.b pedoc1, or the project Mill be toDIll1erea Bben4onea.
<br />mN I r" TO QWM8R: YOUR PAtt.URI to RiCORD A IOTlCK or COlKPCIHI1II KAT RlSULt III tOUR PAUlO fllCS fOIIIlPROVlDltS 10 tOUR
<br />PROPr.PH. IF YOU InSKD 10 08Tll1 PlMARCIJG, COISULT WIlli YOOR LIMDIR OR AX AnORRn 8EFORB 1tICORD1RG YOUR JfOfICl OF
<br />COKME~C&HgHT. JOBS UNDER $2,500 11 VALUB DO Mot .ao fO RlCORD aID POSt A 'lOtlCl OF .... .
<br />I -
<br />
<br />~dt{::miT~
<br />
<br />
<br />{ Na 1.'; -'fyped ,
<br />nOT(~Y PUDLIC
<br />
<br />STAyg OF FLORIDA 1 '
<br />COUMtt OF /~ /l/ EL .(,4 S
<br />The foregoing instrument wat acknowledged
<br />before me this /-J./ '7 ,r 199,7 by
<br />
<br />"hoCt: :e;~~ii/;J. "t~~ H lIf lIhIl has
<br />
<br />produced [~,-t! ~CJ /Y ,-1 { ~ 'r' A (V6 G-<.J
<br />as identification Bnd who ~ldldi~A~ot
<br />ta~'" an _~fttb '.....~,.< - -.....
<br />,M A. WEBB
<br />8 gnature) Notary PubllC.- ate
<br />My Cof1VTUtIOn EJcplres Aug 5. 3:lOO
<br />(~ame Typed, ~inte or St
<br />NOTAllY PUDLI
<br />
<br />
<br />
<br />STlln: (1~ FLOnlDAj},. _ '
<br />U)ijN!Y :)f J /15 co
<br />The foregoing iostrUJ1lent lif4S ~~~OWleclged
<br />bef\l[O n1e this /~ c? , 19. by
<br />
<br />.1..d.<!5f/,-J'-c'C,' ~, ~;;/!~~~b
<br />who 18 p9rs~ally known to m~ or who has
<br />pcoduced L;F.{!'::>6/1//I~Lif /f#oc.dN'
<br />a6] dentificat -wlm-4id/di,.:a,,~j.
<br />!:a):"i~ an7 oath. /' ' \to .....
<br />_.J.,._~ -'1" t/ KARl.~. WEBB
<br />(sF, 1\ a lute) My CommIsIICln &pires Aug 5. ZXI)
<br />CornrnIIIIon f CC562161
<br />
|