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<br />, .', ""i'fItAN$ JQN IMPACT/UTILlTIES,IMPACT AND RESOURCE RECOVERY FEES: The undersigned Understands
<br />'th~dtrEl "n Impact Fees and Recourse Recovery Fees may apply to the construction of new I:;uliclings, change of
<br />uslij iri ~;, ings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
<br />9():'-{)7i8S/ C1. The undersigned also understands, that such fees, as may be due, will be identified at tHe time of
<br />pei"niltting.'k,'urther understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br />i'eteiving a,~~ltifipate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
<br />fin~1 power I'ei@~se, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
<br />fees are dlieiJ~~ymust be paid prior to permit Issuance In accordance with applicable Pasco County ordinances.
<br />CONSTRUcflo'fLiEN LAW (Chapter 113, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
<br />certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien law-Homeowner's
<br />Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
<br />other than the .0Wner", I certify that I have obtained a copy of the above described document and promise in good faith to
<br />deliver it to the "owner" prior to commencement.
<br />CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information In this application is accurate and that all work
<br />will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
<br />hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
<br />commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
<br />construction, County and City codes, zoning regulations, and land development regulations In the jurisdiction. I also
<br />certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
<br />my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
<br />Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment.
<br />Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
<br />Watercourses.
<br />Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
<br />Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
<br />Septic Tanks.
<br />US Environmental Protection Agency-Asbestos abatement.
<br />Federal Aviation Authority-Runways.
<br />I understand that the following restrictions apply to the use of fill:
<br />Use offill is not allowed in Flood Zone "V" unless expressly permitted.
<br />If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br />"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
<br />licensed by the State of Florida.
<br />If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
<br />construction, I certify that fill will be used only to fill the area within the stem wall. .
<br />If fill material is to be used In any area, I certify that use of such fill will not adversely affect adjacent
<br />properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
<br />the conditions of the building permit issued under the attached permit application, for lots less than one (1)
<br />acre which are elevated by fill, an engineered drainage plan is required. .' . .
<br />If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner ~f the permittln~ conditions s~t forth In
<br />this affidavit prior to commencing construction. I understand ~hat a s.eparate perm~t. may ?e reqUlr~d for elect~lca.1 work,
<br />plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically 1n~luded. In the application. A
<br />permit issued shall be construed to be a license to proceed with the work a~d not as authorr~y !o. vlolat~, cancel, alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a permit prevent the B~ll.dlng Official from the~eaft~r
<br />requiring a correction of errors In plans, construction or violations of any codes. Every ~ermlt Issued. shall become. Invalid
<br />unless the work authorized by such permit is commenced within six months o.f permit Issu~nce, or If work authorrzed .by
<br />the permit is suspended or abandoned for a period of six (6) months after the time th~ work IS commenced: An extensIon
<br />may be requested, in writing, from the Building Official for a period not t~ exceed mn~ty ~90) dars and Will demonstrate
<br />justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the Job IS conSidered abandoned.
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<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. , . -
<br />FLORIDA JURAT (F.S. 117.03)0 'I . j,. 0 '. -aX
<br />OWNER OR AGENT ~J1J _'~a. CONTRACTOR~,{ "-' -' ci::1&
<br />S~l>od and '"""" to (0' ._"") bafo<e m."" tr sm.~"" and ~!::c.~"")0'~0: ~;;:~::r ra" ++
<br />\ L1-1 L~ by fn,d"Y1m (l~/lh052. ,('ou. VV!t 110( onally known to meorhaslhave produced
<br />Who Islare.l'ersonally known to me r has/have produced ~~ sSr;: Pl>ru ~ L\ ~ ' as Identification.
<br />0'- 5+ };:If \J lZ.. w. {\_ as Identification. -'
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<br />Gf'DEED RESTRICTIONS: The undersigned understands that this permit may be subject to jjdeed~ f@sitlctiolis~
<br />f'n9re restrictive than County regulations. The undersigned assumes responsibility for tompIlM.S(!,' I ' "
<br />'restrictions. ." ' " .' . ,,;) <",;
<br />:t:jNTRACTORS AND CONTRACTOR RESPONSIBILITIES: , IftheoYfnefhas., hife.6<' '
<br />aijrtake work, they may be required to be licensed In accordancewit~staleai'1dlocalr
<br />)lIq(!nsed as required bylaw, both the owner and contractor m~ybecitedJQ~,a. ffl,i,~"~'
<br />f.,it the owner or intended contractor are uncertain as to wh~tllt?~n~,i~gtEk1U.lr~rnent~, ......,...j.. iF
<br />. are advised to contac,t the Pasco County Building InspectionDiyi~iiJIi:#Uc@nsiQg~ .,l~.7~84j::"; !.
<br />, if the owner has hired a contractor or contractors, he isadvlsedJohave~I1@,)CJrtstsl~n!!;;
<br />tractor Block" 'of this application for which they will be responsible.. If youiasthe~WIi~fsi~f1 ~t;,. tHe,'
<br />y be an indication that he is not properly licensed and is not entitled to pertrutting pflviiijges. if, Pasco
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<br />Notary Public
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<br />Commission No.
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<br />Notary Public
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<br />Commission No. '. --:~\"~!~, Karen L. Miller
<br />:',.' ,(~, \"~ Commission # DD609664
<br />d:<' .. - 0 er 0
<br />Name of Notary type . "p'" II:' " Bonded Tilly Fa.n ,'nouronca, Inc. e00-38S-1019
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