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<br />L.Crn!i1nJl..L.i) DUlWJlI'll.,
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<br />r^A ~C, 01J-'O~-VU~!
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<br />A. NCrICE ()jf ClED llES'I'IlIC'Z'IONS
<br />~.!"" ,l!ld"'c..ign~d und,n'~t..,,(:je that thi.. parll,it may b.. .....hj...,t tc ~d..ed c...-rric-ri,..,.." whiQh
<br />lO"y be ."'r'e ",.e",t:Cl.ct,l.Vto than Ci ty regulations. The I.:nder:;iil'ned &8awn6a. -t'esPo!lsibili ty tor
<br />COlflp) lane<< wlr.r. any applicable deed L'e.strictions.
<br />8. UW,ICENSED CONTRhC'l'OIC'l AND CONTRACl'OR RESPONsraILITI&:S
<br />If tt,,. OW~l"r h.." hired a contractor or contract.'jrs 1;0 undertaJ<.e "'<n;k, they may be required
<br />to bE! licens..d in "Ccordance with lItat_ and 10clIl re'Ju:at10n... It che cimtracrcr is not
<br />l~censed ~s required by law, both the owner ano contractor maz ba eit&d for a misdmmeanar
<br />viol.1tiol1 under IItate lal" 'If the owner Or intended contractor ",re. urlCol~.tea.in /11$ ~o what
<br />j,~?6nsin9 requirements may apply for the int&hdllcl Work, thwy are advised to oont.ot the
<br />City or 2ephychille BU11d1n\l D'3partment, 813-.760.-0.020.,
<br />F'lr'Cl".ermore, .if the Clmer hall h.j.r"d iO contractor or OOlltriloto".." he 19 adViseCl to have t.hEl
<br />contra<:tOl:'("J :!Ii..r: POj:'tiona ot the "Conr.:~..<'tor Sa.:::tiOl)~~ of thilJ al?p1ioati.cn fo::- which they
<br />w~ll be r~sponsibl... If you, as the owner SignB &S the contractor, YOy are indicating th4t
<br />you, n.the,. r.han the coni:ractoL, ax.. responsible for the work. It the contra;:,tor \.ishes
<br />.\I':m t.o "'i\lfl as centractor that may be oSn ~ndicat;ion that he ia not; pro..e'~ly l:censad and ts
<br />not ~"1t;i.t1ec! to perro;i.ct..n<} privileges i'n the Cit.y of Z&phyrhills.
<br />c. 1'RAWSPORTl.'l'IOtl IMPACT FEES AND UTILITY CONNIi:C'i'ION FEES
<br />O. CNIB'I'RtJCTOIObl LII!:!J LAN (CIlAi'l'li:fl 713, r:'Ol'lICA STA'l'OTES, As AMI!;NOltD)
<br />I certity that I, the ..ppl~oent, hOlV.. be..n provided w;.th a oopy of "Florida's Con"'truotion
<br />1iG11 Law - HCQQownQr'. Protection G~;.d.." pr"p*rGd by enOl Fl~rida OGparcm..nr of Agrioulture
<br />and 8or".umer ;,rta.it'liI. It the apPlica.nt is someone Other that the ".ONner", I oerity that I
<br />h~ve Obt&lned a. COpy ot the abOve described document and promise in gOOd talth to deliver
<br />i.t tu the "owner'" p4:ior 1:0 oommencament.
<br />i. C;ONTRAcTOR'S!OWNER'S AFFIDAVIT
<br />I celt.it'y that all the information i'l this "Pp1io"'tion i~
<br />n.. 0<""8 .1.11 COIllP11.Eloce ',tith all applicable la."", :l:equl...ting
<br />dev,,:.opment.
<br />A;::pl.~.c::at.ion is herebjo ~ade to Obtain a pe~nlit 'co do .wad" ,md installacion 21'" incti"atOld. I
<br />esxt,.fy that !'lo work or in5tai1e.tion hail "'''mm..ncecl prior to iS$uanc.. at: a parmi:: and thlit;
<br />all >lork will b. pertormect to meet stan<lants of all l"ws ~."9ulatin9 eO~'''l,,'uction, City
<br />o:Jd6", ~oninQ r"\1ulat:iona, ana land deve~oplll.";: ragulations in tho. jur;i..jcliction, I ..:teo
<br />'~",rtj.ty tha1: I ...nderstand that the r..gulations ot: othOlr gov$rnrQ'ilIltil1 ,ag~ncil;o.s may aPPly .to
<br />ttl~ :.ntended work, and tl1&1; !t .18 my reSpOnSll:lil.it.y to l<i.otif~' what llcciollS I mu.t take to
<br />bs in compli~nc~, Such a\lencies i~clude but are not. li~it.d tOI 'uapart~sn~ or
<br />li:nvi:o.'onm"ntal RQ9Ulat~on-Cypre"s Eayh_ads, Wetland Areas and Ji:!l'lirClnmentally Sensitive
<br />Land!I, Iiat"r/Wast<;;liater Treatment
<br />*5/out:hh'aat ~'lorldc. Water Hanagelllent Di"'trict-W"'lls. Cypr..s~ Bayn..eds, Wetlapd Are618,
<br />Altering Waterocuraes
<br />"'Army co~'ps ot: Eng::.n..e.)....-Se"l-Ja~l", Dock..., NavillAbl.. Wat..rwi'y"
<br />"Cepc,rtment o=: lIeotlth Ii< R..habilitlltiva SerVices, E:ovironr.,e:,tal Hbalth Unit-Hells,
<br />W-s"t<tw..ter Troatrr...nt, aepr:io Tanka .
<br />'U.S. Envircnmental Protection Agency-Adhaatos abatement
<br />I ..1"0 ,O.IlL.t.1fy that, if fill a.ateria1 i" to "''' usad 1 n Flo j 4<'1l9 "A" or "A, ..tc. ~, it is
<br />'undeJ:",ood that" drainage plan addre8l5Jn\l .. "cOt:lp"nsat1n\ volUllte" will be SUbmitted whioh
<br />i~ prepared by a prote.ssional engineer registered i~ the "-~te ot Florida prlor to p~rml~
<br />.is.aU.c:Ulce.
<br />A pennl.: i$~l\.;..d Shall be conat~.u"d to be a lioe".... to P:::C "ed "':let! the worK and not as
<br />aiJth<'~'i.t}' to v;\.c.l.at>:l, cancel, alter, Or "et a"lde any pre' '"io,",,, of th.. technical cede",
<br />nor "lla11 ia;iH.l.ance at .. perIni,:: pr"vent the S'-lild!ng Oft Ie .1 froll', the:e'eafter requiring a
<br />o':):l;r..ction o[ errors in plan"" cOnstruction, ar violatior. of any. l~od6. Every permit
<br />i!ls.....d ..hail ;:'''0011I'' invalid unl""e the work authorized b ueh permit is OClI\IlIencej with1n
<br />six r"'ntl~8 of i","ua.nce, O~. if wo~'k authorizeQ by the peri ..t 1.. SUllP9r1ded or a<oandon"d tor"
<br />a",ri"cl c,( $11( 111l1nth.. afbu. 1:h.. time the work is oOlrllNln,,,,, On.. 90 day extension Of ::1me
<br />;;'oily t'e aile-wed for the perllli t with fee <;!l1.rqe ot $15.00. :'11& ",,><t":'810n ..hall be r"que",red
<br />J.;J "..-it1r:;1 to the Building 01'1'ioilll.l. iUl llpprov..d inspeC~()Il must be log-'iled during eaOh $.ix
<br />lOOutr, pericd, ,:>r th.. proj..ct will b.. con8idOJ1'ed ..bilndon.,J.
<br />WARNnJG TO OWNER: "{-:JUR FA1J.,UIU: 1'0 Ri:COJ;(D A NOtICE DB' C( olHENCE.MEI~l' MlO.Y l1.i:Sl.!:>'T IN YO!J"
<br />E'AYIcIG Til"!CE H'DR Il-1PRQVli:I1i:NTS 'ro YOUR P:ROPERT~. rr YOU rt~TIi:I..D TO CST,/UN li'rNAl~CING, CONSOL~'
<br />WITH :tOllP. Li:NDIi:R oa Al~ A'1'~'ORNEY 8EE"ORI;; RJi:CORDING YOUR Ne nCIi: Oi. COHMENCEMEN'l'. JOSS UNOI!:!\
<br />$2,5();).W VAl,Uli; [iO NOT llE~D TO FlECORD tiND POSiT A "NOT1Cf OF COMMENCEr'lENT".
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<br />SIGNATURj, I Ol-iTAACTOR -
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<br />accurate ~n~ thot~all work will
<br />con~~ruction. zoning, sod land
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<br />~'1-Ld~~_~_____~
<br />OWNEIl, OR AG~NT
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<br />STAT!: OF FLORID;:,
<br />COUN'!~Y C F
<br />'rhe for"'gOi.ng in"'trUll',er,t ~las aC!mawled>Jed
<br />B&t:a:o:e me this _ day of _, 2(:-
<br />by __..___~_. . .~
<br />,nam.. <:.1: P'fiCIiIOJl aCkllOwle':lgedi
<br />o who Ls p&:rsonaJ.l.y kllo1~n to Die, or
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<br />&;ho has prCQ:).:;ed.!:f/36'O;('1'~.530&7'1o OJ..
<br />(type of i.<'ler.tl!ieaticn)
<br />and ,,}i:>Odi,j [Jdio: no;: tak.. an oath.
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<br />s'rA:!'&: OF FLOIUDA
<br />COUNTY OJ' ~___.~____...._._.__
<br />The ter.. loin] instrUlU~nt was a.OICl'lo;~led<;Jed
<br />S"1'or.. Ill, this ----Aay 0':___, 20_
<br />by
<br />[lam.. or pereo~ aCknOwledged;
<br />C1ho i. PQrSOnally known to me, or
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<br />ff:ho . \~& j:orOdUCilO UJ 3o!L~ s 3 ~.f5?_. /),L
<br />(t~'pe o.t: iaell'.:iticllLccu:
<br />ar.d h'h" Odld D;jj d nor tal<e an oath
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<br />Signatl.t.. cr pereQn tll,kin9 llCknc>\dedgment
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<br />S l.gncl't:ure of poracn t.~J'.1.r-.':J aCknOw16dgemeTJt.
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<br />~_._--.._._-~
<br />N",m.. typec:i. p"intec! or' at..,n!)ed
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<br />-------I
<br />N;ame .
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<br />,d; print.;;;-o;- stampaad
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