|
<br />/.. II'}I I ,ii, \;1' j;II<I';11 HI!:,'::i'J'IUC'J'jOHS
<br />'1'111:; lI11derslVlleu 1llldel.'stands that: thJs permIt may be sllojeut t:o "deed u:lsl:rlct\l)\lS" \/1l1cll
<br />lila,V be IIICHe restllcLJve l:han CJty L'egulations. The undel:s.lgned aSSllllltHI 1'6spons1.hlltl:y ":01
<br />cOlllp.1 lance III t:.h flny app1.tcable deed res\:r:1.cl:j,ons.
<br />B, IJIH.JCHiNSI!:!1 CON'j'H1\C'I'OHB AND COI'/'l'RAI':'l'OR RESPONSIBIl.I'I'IJ!iS
<br />If the Ulmer has Idr.ed a cOIII:r.actor: or oontractoLs to Ilndertake H(>1:k, they may be requ:1 red
<br />1:0 be IJcellsed 111 auuordallce I-Il!:)) state and local. J:891l1atJ0I18. If t.he contractor 1s not
<br />l.1.oensed as relpllL'ed by laH, both the ol-mer and oontractor Inay be oIt:ed for a lid sdsInsano..
<br />vlulation 1111 dell: state la\L If the Ol'lner or i.ntended oontractor ar.e l\llCe.rta:l.n as \:c} Hhat:
<br />I :\.uensj Ilyrel}\d.rclllellts llIay apply for the intended \wrkl they are advised to CJontact: the
<br />c:lt:y of Zephyt:ld lIs Bul.ldlng Department, 013-'/86."661l.
<br />F'ut'Lllerllloi:e, If the OHller haa hired a contractor or contr.actors, lie is advtsed to have the
<br />cJcmtrac;Lor(s) siyn portions of l:he "Contractor Sections" of tills app,U.aatlon for Hldoh they
<br />.Ill I be respol\sible, If }'DIlI as the O\.mer signs as the oontractor, you are lndtoat1ng thar.
<br />you, ra\:her than the contractor, ar.e responsible for the work. If the contrilClt:or \-/.Ishes
<br />ynll 1:0 s.lyn as oOlltr.actot that Illay be an indlcation that he 1.5 nol: pJ;oper1y l.icensed and .Is
<br />liot: entll:led to penllit:ting ptivileges 1n the City of ::',ephyr:ldlls.
<br />c. 'l'R/\I.IBl'OH'j'NJ' [ON U1PAC'1' FEES AND U'j'ILITY CONHEC'I'ION /l'EES
<br />n. COHS'J'RIJC'{,lJION I,IEH lJ\W (CHAPTER '713, FI.ORIDA S'l'A'I'lJ'I'E,'3, AS AHIr.NllED)
<br />I cel:t! fy that: I, the appllcant, have been provided Hlth a copy of "Jl'lod.da's Constt'lwU.on
<br />1 j en l,al/ .' lIollleol-mer's Protection Guide" prepared by the J!'.lorida DepaJ7tment: of Agr:lclll,l:.\u:e
<br />and COIIBlIlI\er JU:faJr's. If the applJcant is someone other that the "OI'lller", I cEntfy that I
<br />Ilave obta.illed a copy of the above desoribed document: and promise in good faJth to del.iver
<br />1. t to the "oHnel:" llr.1.or to l10l1lffiencelllell t.
<br />E:. CON'I'HJ\C'j'OH' S/OWNIl:fI' B 1\Ii'I!'!flAVI'l'
<br />I oertlfy thai: aLl. the informatJon in tlds applicatJon :La accnrate and t.hal; all Horle \"1.11.1
<br />be dOlle .1.11 compU,allce u1.th all applJaable laws reglllatlng const.rIlCltion, zon.1.ng, alld land
<br />development:.
<br />Appl.l.oal..lon .is hereby made to obtaln a permJt \:0 do wode and l.nstallat.1.on as 1.lId:lo8ted. I
<br />cerU f\' thaI: no Hode or 1n8tal1a1.:10n has oommenced pr.io,r to lSSltallC8 uf a penn1.L alld thaI:
<br />a] 1 V1ot:k wll I be pel:formed to lIIeet standards of all laws reglllat1.ng OOllstUlCItJonl City
<br />()odes, zonJng reynlal:lontl, and land development'reglllatJons 1.n the jllJ:.lsdlatJon. '( alsn
<br />ce.rl:l fy 1:I1aLI IlIlder:st;and thaI: the l:egulatJons of other governlllental agencd.es may apply (:0
<br />the Jllt:endecl v/Cnk, and that 1t is my responsibility to 1dentlfy v/hat: aut.1 OilS I lllllst Lab. Lo
<br />be ill cOlllpJ Lanoe. SlIch agencles Jnclude bllt are not limited to l *Department: of
<br />H:IIVi ronmen I: a 1 Heg uJa l: 101l'-Cypl:ess Bayheads, We tland 1\l:eafil and n:n vJ l:OIlr1l6nt.a 1.1 y SensJ 1:.'1. VEl
<br />Lands, Wa Le r'/Was Lel~a \:er 'Jlr ea tment
<br />*S~)lIthHes\: F'l.od,da Water Nanagement IHstr.tct-Wells, Cypress Bayheads, Wetland Al:eaa,
<br />AIted,lIg WatercOlIl:ses
<br />* 1\rlUY Co rpil of mug! i1eer:s-BeaHalls, flocks, NavJ.gable Wa terways
<br />"')lepar:tmenl: of Ilea 1 tll & Rehab1..Utative Services, J!:nv1.ronmantal Health lInJt-Wells,
<br />WasteHater 'j'raatmeu1:, Bept.lc Tanka
<br />"'u. s. e:llvJl:ol'llnental E'1:otec:t:1011 Agency-Asbestos abatemeut '
<br />'[ also cet\::! f.y that, Jf fLU l1IaterJa1 Js to be used 1n Ii'lood Zone "A" or "A,el:c:.", it :Is
<br />understood Lhat a dra1.nage plan addreasing a "ooll\pensaU.ng VOllHne" Hlll be suhm1.t:t:ed I'IId.ch
<br />Js pl:ep~t:ed by a professional eng.l.neel:' r'eg.1.ste1:t~d in the state of l!'lor1.da prJo[' 1:0 pet:lld,t
<br />iSsl18nue.
<br />A pe1:1IIJt j fislIed sha 11 be (Joilstrued to be a license to proceed Hith the Hark and not as
<br />authod Ly t.o vlolate, canuel, alter, or set aside any provisions of the teohnlcaJ. oodes,
<br />nor shall iss\1allce of a permtt: prevent: the BlIJldJng Official from thereafter re'1u1r1119 a
<br />correuU,ulI of el'.l:ora ln plans, aonstrllol:ion, or viol.ations of any oode. Everv perm.l.t;
<br />i6s\1ed shall bS{Jome invalj,d unless the work allthor:ized by auah perm1 t 113 aOJlllllenueri w.1 Ud II
<br />Sill m011ths of 18l3llanoe, or if \'I01:k allthod.zed by Lhe permlt 1s suspended or abandoned for a
<br />pad.od uf sl)( mOIlUls after the t:1.me the work is commenced. One 90 day eJetens1011 of tlllle
<br />lIIay be a1 LlJl-led fat: tile permi.t \'lith fef$ charge of $15.00. '{'he e)(t811s10n I!lhal.l be u~qllesl:ed
<br />III \'Il:iting 1:0 the BuJldJ,ng OffiGial. An approved inspection mllst; be logged d\l!::! ng each sla
<br />month period, cn: the project \oIJ11 be cOllsldered abandoned.
<br />W1\Rl'lJIW 'I'() OWN lUll I YOUR H'Alr.unE '1'0 RJiJCORD A. NO'1'ICE OF COMMENCIDMf!:t~'1' MAY HffiS\JJ/l' IN YOIII\
<br />PIIYTtH. 'l'WICli: Imp. H1l:'ROVEHEN'I'S '1'0 YOUR PROI?JiJR'rY. IE' YOU I1I'l'EHD '1'0 OB'I'/UN If'JNAIIClIH3, CONSIIL'I'
<br />WITH YO\lIl l.H:lllJF.:H UH AN A'I"l'()RHJl~Y BElroRI!~ RECORDING ymm NOTICE Olr COl'1MENCH:ME!',II'J'. ,fOas 1JHlllf,H
<br />$:2, 50 U III VALlJ Ii: DO 110'1' N I!:ED '1'0 RECOHD AND POS'l' 1\ "NO'l'I Chi Oh" COHMENCEMli:tl'j'".
<br />
<br />~~~-----_.
<br />
<br />SWN1\'j'IIHE: I CON'l'R1\.C'I'OH
<br />
<br />~,
<br />
<br />..._------~_...--_..._" ._~..._---- '.--..-.--- ....-- . .--....------.--......---...-.--..--.-
<br />
<br />SIGIIA'l'Un!!:l
<br />
<br />OWNER (lI\ AI;EtI'l'
<br />
<br />S'J'A'l' iiI 0 Ii' Ii' j ,oRI I)A
<br />COIIN'!'Y Oli' ,__,_____ ....,_______.___,__,_
<br />'J'be toregoJng l.11strlllnellt: VlflS ackllovlledged
<br />BeEol:8 me \:Ida _""'_'.'_ day of..,___,____,_., l!t._
<br />
<br />by _,..,_.__ ,.. ____...__._._._'."________.__.__.._._____._,.
<br />(nflme of persoll aolmowledged)
<br />[] I-Iho is personaLly klloHn to 1IIe, or
<br />
<br />[] Hha has p I:odlloed______.____..___
<br />(type of identification)
<br />and whol] cUd []dJd not taJ;e an oath.
<br />
<br />._~----_._-----_.._----------_._----_._------_.._._--
<br />
<br />Signature of person tak.t.ng acknoHledgement.
<br />
<br />_..._-~,..,-...._-__.______.__. 0.- .__..._._._.__.____..__._.......____..____..
<br />
<br />Nallle typed, pdnted ox: stamIled
<br />
<br />- _....:: I ',,'.'
<br />
<br />.tl:..; '_'.~ ,k \)
<br />
<br />S'l'A'I'E: Ol!' IT'LORIIJl\ <t"'t
<br />COUN'I'Y Ob" .-'l:.~~c:L...,_._~__,__....._,_...._
<br />'l'he foregolng 1.11Sl:rl.11ll6nl: Has aoJOJol-/ledysd ~
<br />Bafo~ ~_\s,lay 1}.f~--_;-+9-~ ~
<br />by '._,____. ~ ~,._~~_"_____.
<br />(name of person acknowledged)
<br />[hho is pel'sanally Imown to me, or
<br />
<br />lJ Itlho has Pr.OdIlOl\tcl_,...,__.____,____,.._.,..,
<br />(type of Jdellt1.fJ,:at:l.cnl)
<br />and Hllo Ddld ~Ud not talee an oath
<br />
<br />~~..'~-,----_._---,_._-,_..
<br />
<br />SJ.gnature of persoll tak.Lng aCkllPHledgrnellt I
<br />
<br />~ .. ~~.._-----,--,.._,--,_..
<br />
<br />f~I~~lIil(~ty~~ct'INA.. -- or a l:amped
<br />!:.; , 1< ~y CO~MI SION 1/ DO 080623
<br />Ii ~ EXPIRES: December 26,2005
<br />" '<<" 0'" Bondod Thru Budget Notaty Services
<br />.--- -------..--+-- .. - -~-~
<br />-~_...~.......- .. ..
<br />.-- -- ~_-'.._'.._r....._...~.
<br />
|