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<br />LtI'.\' .'J!, '.'.1-'" r,Jt} S O.~ :~E~?j\1?:'r AFH'I D,A'VI T
<br />
<br />A, NO'J'lCfll Oil' DEJBJn RElB'l'RIC'I'IONB
<br />'l'be ullde1:fjlJyned 1l11der:stands that t.hj a p~:lllll_ mOl y' bt= a\lbJ~(;t 1:0 "deed rest:dr::ttons" Hhich
<br />llIay jJe III0J:e 1:estl.'JcLive than CJty Leynlal:iOIJs. 'I'he \lnderslqned aSSllmes l'espc>Hsl.b,11Jt:y for
<br />compLiance Id.t.h allY appl.icaLJe deed LBstlJC~joll,=.
<br />B. IlN J.J CHiN BIliU CON'l'Rl\G'l'ORS AND CON'l'HI\C'1'(lj" RlI:S POH S B I LI'l'IE:,s
<br />J f the OIllIer lias llir:ed a cOlltJ:ac\:or UJ. ,:ont_:act:oul to llnderta)(e I-/Ork, they Il\ay be reqllj red
<br />10 ve l:1eensed 1n acoordance HJt:h sLate and IDea.!. J:egulatJons. If the oontractor :Is not
<br />LIClellsed as req\IJled by Jaw, both the O\-lIler alld cClntracl:or may be olted for a ndsderneaJlor
<br />vTolation \Il1deL stal:e laB, If the o\'me.: OL JntlHlded contra.utor: are \lllcel:t;aJn as to I/hat
<br />] lU611SJIlY reqllirelllellts lIIay apply torUli; intended I'lOJ:k, they are advJsed to non taut: the
<br />City of Zephydd 1.1 s BuJldlng Department, 013-"/80"6611.
<br />Ii'urlllstlllol:e, if the O\'/IIe1: haa htl:ed a contJ~Clctor or contractora, he Ja advJaed to have Ule
<br />ClolltJ::act:or (a) si.gll port.iolls of the "Contractor Sections" of this app.lJoatJon fot \lh1ch they
<br />I-IUJ be responsJble. If YOIl, as the OHner signs as Lhe contractor, YOIl are Jlld_luating that
<br />you, rather thau the contractor, are respons.ible fOl: the I/Urk. If t.he cont.raul:or \JJ shes
<br />\,flll La stYli aa coutt'actol. that lIIay be an indJcatioll that he.l.s 1101: properlyUcensed and is
<br />nul ellt:! t1 ed to perllltLt:illg pri vilegea In the Cj ty of :l,ephyddlls.
<br />c. '1'Rl\NBPOH'1'l\.'1'TCJN JHI:'AC'l' FEElS AlID U'l'ILI'l'Y CONIIEC'I'ION If EElS
<br />n, COI/B'l'H\JG'I'UIOH l,TEN l,l\W (ClIAP'l'ElH 71.3, FLORIDA S'l'A'l'U'I'ES, AI3 At1ENDEm)
<br />'I oel:l:i fy that: I, the <lppllcant:, halle been P1:ovicled \11th a oopy of "E'lor-tda' a Constt\\OtJon
<br />.l ten Trail - !Iomeol'/ller's Protection GuJde" prepared by the E'lorida Department of Ayr.iculLlIre
<br />and ConslIlIler J\ffaJra. If the applJcant is someone other- that the "ol-Iller", I oeelfy Ulal: I
<br />have ul>t:aJ lled a copy of tbe above deacr:\.bed document: and prolO:\.se in good :faJth to deli,ver
<br />it to the "Ol-lller:OI prJot to CDmrnencemellL.
<br />ill, CON'l'Hl\CTOH' B!OWHIDH' S J\/i'/i'IIlAVl'I'
<br />l certJ ty tlla\: all I:lle infonnatJol1 in this applicatJon J/3 accurate and that all Horl, \Ii 11
<br />be dOlle 1n compli,ance l/1th aU_ applicable laws reglllatillg oonstruotion, zoning, and land
<br />development:,
<br />AppllcaLioll ls hereby made to obtaJn a permJt \:0 do work: and ills Lallation as :\.ndloated. I
<br />ce1:l:J f.y that 1\0 \lori, or instaU,ation has commenced prJor to issuance of ~ peun.u: and Lila\:
<br />all v/oJ:k \~Lll be performed to mest standards of all laws regulating Clonst:UlCItlon, CII:y
<br />c:odes, zonJng regulatJons, and land development 1:eyulat1ons 1n l:he jur:\.sdlc\:ion. 1 also
<br />celUfy thai: ':[ 11IH,iersl:and that the reglllatJons of other governmental agencles may apply to
<br />Lhe Jntended 1-1Ork, and that it is my rfilsponsibiU,ty to Jdenl:lfy I,that Clotlons I 1I\\1~1: \:ake 1:0
<br />be 1n COlllp llanos. BIlCJh agencles .inolude but are not 1Jmi ted to: "'Department: of
<br />F.:nvirolllllental ReguJation'-Cypress B?lyheads, Wetland AL'ea~ and Environmentally Sensi.t,lve
<br />TraIH.is, Wa Le l'/Was teHa tel' 'l'reatment:
<br />^SOUt:hW6l:il: !i'lorJcla Water M'1nagelllelll: UJatrict-Wel1s, cYPli:ess Bayheads, Wel:lalld l\J:eas,
<br />J\l\:edllg WaterDourses
<br />^l\rmy Corps of Illngiueer.s-BeaHal.ls, Docks, Navigable Waten1ays
<br />Allepa!:tlllenl: of lIeal1:h 6< RehabilitatJve Ser.vlces, EnvJl:onmental Health 11nJt-Wells,
<br />Wasl:eHater Treatment, Septic '.Panks
<br />All. S. EillvLronmental ProtectJoll Agenoy-Asbestos abatement
<br />T also mnLlEy that, Jf fl.U_ materJal Js to be used 1n li'lood Zone "A" or "A,etc.", it is
<br />IUHlersLood that a drainage plan addr-essJng a "compensatJng volume" wlll be suhlll.1 tted I/hlch
<br />is pL'epared by a p1.ofesslonal engineer reglstered in the Stat.e of ll'lor.lda prJor' to permt\:
<br />issllalloe.
<br />A permIt lssHed ahall be construed to be a i:l.cense \:0 pr-oceed \-lith I:he work and not as
<br />authorJl,y t.o violate, oalloel, alter, or set aside any provi.sions of the teohnJoal oodes,
<br />nor shall i ssnance of a pel:mi.t prevent the BuLldJng OffJcial from theL'eafter requldng /:l
<br />con:euLJon of erroJ:s in plaus, construatlo/1, or vi(~latiolls of any oode. Everv permJt
<br />lSsHed ahall beCome invalid unles" the wo.r;k au~hodzed by slIah perm:!t is (Jollllllerwed witldn
<br />sbt months of issuance, or Lf Hork authorJzed by Lhe pennJt; is suspended or abandoned for a
<br />period of sb, lIIonths att:er the tlme the work is OOl\m\enced. One 90 day eJlt:ens1on of t llIle
<br />lIlay be aUol-led for the per-mi.t with fee charge of $15.00. 'J'he e~ltenslon shall be requested
<br />In \lri\:1I1g to the Building offi(~ial. An approved Jnspeotion must; be loyged dllrjng each S.lll
<br />month ped.od, oJ.- the pro:} eot wL11 be consJdered abandoned.
<br />WI\RNIUG 'J'O OWNElRI YOUR IfAIl,URE '1'0 RECORD A NOTICE OF COMt1tr.NCEt-ftr.N'l' Ml\Y HmflllIr'l' HI YOIlf\
<br />P.AYIIIG 'l'WICE: B'OR U1I?HOVEHEN'rS 'I'D YOUR PROPER'l'Y, IF YOU Il/'['EIID '1'0 OA'l'AHI Ii'HIAl'Ilallla, COIISIII/I'
<br />WITII YOI1f\ I.E:l/IJER OR AN A'l"l'ORNF.lY BIliIfORID RECORDING YOUR NOTreI!', m" COMl'1E:NCEI'1EH'l', ,fOBfl IJJWR:n
<br />$2, SOO IN VAWl!: DO NO'I' NE:ED '1'0 RECC)RD AND POB'J' A "HO'l'ICE O/i' Cut1111i:NCIl:ME:N'1'".
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<br />Si~\#~iJn"G"ji;---------
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<br />f:l'j'l\'J'1!i Uf!' fj'J,URflll\
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<br />COIJ N'j' Y 0 Ii' ._____.______ ._________..________________.....
<br />
<br />'J'he torego.ing instrument was acknowledged
<br />Before lI\e this _.......,__ day of ,_____,_,_______, L!t_,..
<br />
<br />by _'''h_ __,._,__, '_____.._.. "___.'__ __'____ ___ _. ___..__'________.... ..____..
<br />(nallie of perBon aCllmo\~lectged)
<br />I] 1'1110 1s personally known to llIe, or
<br />
<br />Lll/ho lias p rodlloed_____.________~__.__________
<br />(type of identifJeatJon)
<br />and vJhol] cUd LId! d Ilot take an oath.
<br />
<br />....-..._.~... --. ._, .__.__u.~.. ._.. _.____~____._~...."_____._..___.~..._.__.""_.__
<br />
<br />SJgual:1I1e of persoll tald.ng aoknol-lledgement
<br />
<br />j,j ~J,{~--t-YI-)-~~i: -- i-; ~-i'~;-i:~~l--;;~--~-l~-~l~I;~-(j------h.
<br />
<br />-~.~, -_.~...__..._.~._._-_.-,._--..-_.-.."..._--~ --,- .. -. ---"--'--'--",-"~~ '......._.,._..__._-~._, ~
<br />
<br />S I GNl\'l'lI RE: CClN'l'R1\C'l'UH
<br />
<br />fl'I'A'l'E OE' FLORIDA
<br />
<br />COlIN'j'Y DE' ________'___.___,____,,__ _._'..__._._,_________.."_
<br />
<br />'j'he foregoJng 1nstrlllllent \-Ias auknol-l1 edged
<br />Before me this _~___Ilay of---,---------_____, 19 _:.._
<br />
<br />b'j .._..___.____,____.___,___.___ ______ _...__._____.....______...._
<br />(name of person aolulOwledyed)
<br />[J~ho Js personally ImlHm to me, OJ:
<br />
<br />[J who has produoed_______.._________,..___.__,__.__
<br />(type of Jdent:Jf.t.ClaLJ.onl
<br />and 1-1ho l]dJd DUd not t.aJ,e an oath
<br />
<br />.- -'-~..."---_.._---_.,_._,,~--,~..,-.,-"_...- .-- --. -_.,...".~--~-- .-....-. ..--.....-...-....-- '- ~._-,.._------
<br />
<br />Stgnal:ur-e ot pel:S0n taklllg acknmlledgrnent j
<br />
<br />--'--~-'- .,---.,---..._-~----,-_.._~- .....-._~'-~.__._-._-~.._- ......" -~. '-_.~_.,-
<br />
<br />Name typed, pr.lnted or sl:amped
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