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' 3. NOTIFICATION OF COMPLETION: The District is hereby notified that construction of the surface water <br /> management system is completed, and the Permittee requests that the surface water management permit be <br /> transferred to the Legal entity (individual owner or corporate) responsible for operation and maintenance <br /> (O &M) as named in Section 4. An authorized agent must submit a letter of authorization from the permittee <br /> authorizing him or her to e cute this Notification. <br /> By: ,�-- ,,v�. �ivli4'iJ' ►� �� /1 f2r�/�aj" <br /> Signature of Permittee or Authorized Agent Name and Title (please type) <br /> 645645 ZEPHYRHILLS MUNICIPAL AIRPORT <br /> • Permit Number Company Name <br /> 39450 SOUTH AVENUE <br /> Company Address <br /> ZEPHYRHILLS, FLORIDA 33542 <br /> City, State, Zip <br /> 4. AGREEMENT FOR SYSTEM OPERATION AND MAINTENANCE RESPONSIBILITY: The below -named <br /> legal entity responsible for O &M agrees to operate and maintain the surface water management system in <br /> compliance with all permit conditions and the provisions of Chapters 400-4 and 40D -40, F.A.C. An <br /> authorized agent must submit a letter of authorization from the owner or other legal entity authorizing him or <br /> her to execute this agreement. <br /> By: ZEPHYRHILLS MUNICIPAL AIRPORT <br /> Sig -ture of Representative of Acceptable Name of Owner or Other Acceptable <br /> O &M Entity or Authorized Agent Legal Entity for O &M <br /> /0: d� i,�✓ �, 4..r � N. /� 39450 SOUTH AVENUE <br /> Name and Title (please type) Address <br /> 645645 ZEPHYRHILLS, FLORIDA 33542 <br /> Permit Number City, State, Zip <br /> Phone Date <br /> RESPONSIBILITY FOR OPERATION AND MAINTENANCE MAY BE TRANSFERRED TO ANOTHER ENTITY ONLY <br /> UPON WRITTEN NOTICE AND APPROVAL BY THE DISTRICT IN ACCORDANCE WITH RULE 40D- 4.351, F.A.C. <br /> AGENCY USE ONLY <br /> OPERATION AUTHORIZATION: Based upon the certification by the Engineer of Record in Section 2., and the notice of <br /> completion in Section 3., the responsibility for operation and maintenance of the system is transferred to the legal entity <br /> named in Section 4., and the operation phase of this permit is effective on the date indicated below. <br /> SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT: <br /> Authorized District Representative Name and Title <br /> Effective Date (mm /dd /yyyy) Permit Number <br /> FORM 547.27/SOC (4/09) <br /> Rule 40D- 4.351(2)(a)1., F.A.C. Page 2 of 3 <br />