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<br />, COHfJ.tT.tOHS~O''''~I'UH1't.,tAFFIVA Vrf
<br />}\. NOTice O~ vltBtJ nBST'UC1.tO.tfg/lf,,\r.'t'~iil.'~:'l~..~': ...."
<br />rhe IIndu,jgned _erlt.lId. t~t thf. "ratt,..r....!lUbJec..,to~..t.ltrJcUon8. whJch lar be IOrl! restrJcthl! Lhan Cily
<br />reguJIlIOll', tb. Uftc1.rtJ....' blUld .........UUf tor'....1I ..Ilia an, appHcabJe deed restrlctlons. '
<br />. r- rr...'n " ~_.., _ -, " .
<br />
<br />8.' UNLICENS.ElJ.COrrtRAC'J:OltS.AND COH't.hAt'l'Ott ItESl'ONSlBlLlTlES
<br />I( lhe owner h.. hlted . tutlt.etot ut'tdntraetor' to Uddttt*'lllDrl,thtr .,,'be'requlred lo be licensed In accordance wilh
<br />1I11llt am11uell tl9\tllUdIlt., If u.. tGdUlclot II not llttMtd::u t...lt.a br 1.., bolla the owner .~4 . contractor II' be
<br />elle4 tor II II""'n<<u: W.4)I.UOll unc1tr alal,'litt~' U lh.~_f'bt'I"lMc1M.tonttattor Irt uncl!rbln~al~ to'lIhat'llclllllnq
<br />tl!quhel6nU lit Ippl, tft \he Inllnc1e4 NOd, lhIl, It. la,lftd:lo tUntlct lhtI tllr of ZephrrblUI DuUalng Deparllent, (811)
<br />181-&&11. .," ..,,' , . .' . '
<br />
<br />i. '
<br />
<br />. . ""I ,'.:'
<br />
<br />Furlhe[for~~ if lhe ONnllr hal hired. contraclor nr conlracl6tl, h@ 18 edv18ed lu ha.. lhe contrlclor(l) 81gn portions o( the
<br />.conttftlor Betti...' of'~I'.ppllt.tlon for .hleh the, .111 be tilponllble. If JOU, II the owner 11gn all the ton'~aclor,
<br />you ar@ Iddlc.lJnt that fbU,talher than the tunlr'tlot, 'tl r.'~.lbll.tot'lhe worl. If the contractor vlllhp.o Jou'lo 11gn
<br />88 toIttrlltlor lhel II' he In llR1h:.U. Utat he II not propUJ, Uteneedend Ie nolenUUed Lo perlUUng prhUegea In the
<br />CllJ rJf lephythHllI.' '
<br />
<br />c. TItAHSPURTA't10H IMl'ACt FEES AND U'1'.1LITt COHN6C'flUN FEES
<br />
<br />u~ coNSTRUCTION LIEN ~AW \ (CHAPTER 113. FLORIDA.StATUTES, AS AMENDED)
<br />I cerli;, that I, the applicant, h.,. bien prOflaea ,Ilh . tdpJ Df '~Jorlalll Conltruclloh Lien Law - HOIeowner'I'P~l.cllon
<br />Culllg" prf!p.recl b, lhe rIDtld'''''ttMbof,:AgrlC:Ullarl IncI.,tallldtlr AU,lu. If U.e"pp1.1clIIl II lOIeOI1e other thin lilt
<br />"ownl!r-. I cl!fUI, lti.t lltaft obt.lned I topt br lbt lbote d..etJMc1 dotuIent 8nd protls."!n good faIth to del her It to thl!
<br />"0WJIl!t- prior lit toIIItn_nl. " 0';; ."
<br />
<br />
<br />IIppllcatlon I. "'rib, .. tdflbtll~. Plr.l~ tchdo IOr.l~; A.t~IJ.Uon a,' Jlldlclted. " I certUJ Ulat no ,rorl,o[ ,
<br />Jnst,JI.UOll hn' tOllIlll:ta\.dbr:.,tO$~~~ot~. Pita. I~~." ~~.l~,~r"~!.l1 bI,.r~oltlc1, )~ ~.t .taac1arc1a!of all'lal.
<br />rC!gulatJnv toIiahucUtJnj tUt ~.~"'":!t.I.U~,,''''!J.i.l~.~: let;1iUqiitlii'~ JIl~..dlcllOll~J~t".I.o~
<br />rl!rlUr tllllt t ,,"tll_ lhat'the ttgttbUGi. &t ctlhlt "iOllfMAtllf,oltltklH' ..,' Ipplt-lo 't""lnleht1ea wort, Ind that It h
<br />If rl!sP'"llbllltf l~ Id.nllf, ~t"ttlonl~~t...t.~lto,~,I.~~lllnc.. Buch ..enel.. Include but Ir.,not Illlt,a Lo:
<br />. Dep.rllenl ot 1n,1ronlldt'1 legulatJda M;t,.~"~lff"".; IItlldd At... and In,ltonll!nlall, Senlltl.. Landi,
<br />, ':,. , ,', i " !'::': . . '.' :~~ ..bt"'.t~.t~, ,J,ttltMtnt
<br />. SOllth'elt 'lqrld' "a lit lIa=t blUdt~ ,;j IfIU" ~"liti .,.....,. .,. v.tland. Areal, Alterlng Watercourses '
<br />· "rlf Cor... of IIlIlneert ' ~.... ' .1~D,tbt.l~f~".ltl' 'If.llft.,. ,
<br />I Dep.rllent 0 '. filtal ,.'lItt tY ,...'U..W...llh ball - Nelli, 1I.ltlllter lrea_t, 'SepUc lanll
<br />. US IDYlI_tll",. ,.,1, OI....t...t" . .
<br />I ;"'0 C!rl rt, ..ttt.rl..(<<j"btlb..."I".'.~"....A. nr 'A,@tc.., It J, andentood lhit'atdraln~gg plln
<br />addrelllllng ,. ._nl.U....tOJ..~;:ldJl bt .uNltt", ~hl~,lIprepartc1 b, I profelllonal .ngineer reg18terec1 In the Stltl of
<br />Florida prior let IItr.lt.tnUMtf. ,,,,, .. ~"',',
<br />. "pl!rlll blued ..,IU bf atnilUI!ct' Uflit" ~ ..tcerise to ptOtllCf iUh lhe lOll and nol al authorllr to Ylolate, 'cancel Ilter, or
<br />Il!l aRid. anf protl.....l'f tM,~.Jdafd,~...t. "'Jl;~IIIt. of . per.1t prIYent the' bUdlng Olf~cl.1 lrOl tNnlfler
<br />reqUldng . t:OrtteU"" II .ttot...l.:'......ltIftlbfti."iJt Ilotlllon' of' In1 tcJc11. ,.,.ry.llfraW 1.1tIIl1~,"1l"'" .JIIf.lld
<br />unlt'l the Wod Idlhctda.d br....,:pt~~~~,~I~~~l~...,1' ~~ ~f .~~'Uantt, or ,If worl IlItIIorJltc1 bJ the perllt h
<br />IUlIpendect or abandoned lot'I flrJoc1 ori," _(IiI',.rl.~ 1&8 UII,U.. tfOtl'.. ~nttc1. Onl 90 c1I' edlnlllon of lIJ!!, la' be
<br />aIIOll!~ for l~ "till ...th .'..~t9l:~f..lS~II~'~~1~~..ll te requeatea ld .rltln9 to the BulldJng O((lclal. An
<br />arpro,td Jlllpttl1bd lUll' bt l_dtttlng;...,.,.tPlfI.",.,ttf.lh. ,roJect .IU be tonllderec1 abandoned. .
<br />""Rltlle to 0IIIId! ... 'AtUII JOiRItOIIDJA!lIOtltl. 'ItAr '1lur,r lit lOUR PAfJIt' t1fICl FOR I"PROVDIIITS YO lOOK
<br />PROI'lm. ~f..dfl~'!d~~fl"'.!Im " bIoIR OR ~ AnoRltlt llFOIlI R~I.G fOUR .orl<<;J. or ~.
<br />ttMltllUf. .1oM ...,'.J.."l.;..~:,~ ~... .!O~ .I~, ,Hlt"- POSt A ROIICl OF CdllllCDlIIft .
<br />. /!/?b!/ Il L .' ...........,... '/- ~
<br />~~ ~ .,. ,.. -~ ---
<br />SiGRlltURI: onlR OR AGRII ' 81GII tURR: CO IRACTOR
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<br />STArK OF PWRiDA . ,-;), ' ~ "'.' *fAt' U, rtoRlDA iJ. .
<br />com, OF "r It ) ( () tooIm OF ';1 S l i)
<br />Tho tor~voln" In.ttuMnt,..".I,~~knOtd!.dg!~~';,~"'rh~ roregoing instrUllent Mas ackno..ledg~~
<br />before lIIe t:hUi s'^.;t.(.,.J..7 ,!J'.<2~..bj,. ,~.r,ltlrore lIIe thIs "J'-<",^- :27 , C>>OlJ by'
<br />Ifj,~erf JI~f' . _..ft...'. 4/j~ri- J;~5 ' "','
<br />who '1B !~80nIl1l1 known to lie or Mho ha.s t',~.~.,ifiiOi'~ s~r80nal1YknO"n to me or who hau
<br />produce . ,tJtoduce . . --.
<br />dB Idenl:lficatiun and Mho dl. tlut Idt'!.." idehUfication aneI Mho lIid/didnot '
<br />td.~ ....,.... "':.\W~A7<- ~
<br />(Signature) 'o...l~ignature.. ,
<br />...,. 'Hllme Typed,
<br />, ' '~'!tOTARY. PUB
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<br />(Name Type
<br />flOTARY pun
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