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<br /> NOTiCE OF DEED RESTRiCT10NS: The undersigned understands that this permit may be subject to "d�d" ' s"
<br /> w�; be more restrictive than County regulations The undersigned assumes responsibility for complian � fi� any
<br /> � d�eed FesbidiOns.
<br /> CaNTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a cont�actor or
<br /> to undertalce wwk, they may be required to be licensed in accordance with state and local regulations. If the
<br /> is rtat licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
<br /> urui�r state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
<br /> intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
<br /> 8�9. Furttrermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
<br /> pcxlia►s of the "cantractor Blodc" of this application for which they will be responsible. If you, as the owner si,gn as the
<br /> contrador, that may be an indication that he is not properly licensed and is not entitled to permitting privileg�s in Pasco
<br /> County.
<br /> TRANSPOi�TATtON 1MPACTNTILfT1ES tMPACT AND RESOURCE RECOVERY FEES: The undersigned erstands
<br /> that Transportation impact Fee.s and Recourse Recovery Fees may apply to the constntction of new b�in `� �ge of
<br /> use in e�ting buildirygs, or e�ansion of e�sting buildings, as specified in Pasco County Ordinance num -fi�7 and
<br /> 90-07, as art�ertded. The undersigned also understands, that such fees, as may be due, will be identified at th►e tirrte of
<br /> perrrrtting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiv'rng a"certificate of occupancy" ar final power release. If the projECt does not involve a certificate of occupancy or
<br /> final power re{ease, the fees must be paid prior to permit issuance Furthermore, if Pasco County Water/Sewer Impact
<br /> fees are due, they mus# be paid prior to permit issuance in accordance with appiicablP Pascc:o County ordinances.
<br /> LtEN LAW (Chapter 713, Ftorida Statutes, as amendedj. If vaivatian of work is $2,500.00 ��.mare, I
<br /> certify ritat I, the ap�ipnt, have been provided with a copy of the "Fiorida Construction Lien Law—H ', s
<br /> Protection Guicbe' prepared by the Florida Department of Agriculture and Consumer Affairs. if the apptiCant is ' ne
<br /> other ffran tl�e "owner�, 1 certrfy that I have obtained a copy of the above descr+bed documen# and promise in go�rd faitfi� to
<br /> � to the "owne�' priar to c�nmencemen#.
<br /> C�R'S}OtA�ER'S AFFtDAViT• I certify that all the information in this application is ac�urate �rtd worfc
<br /> �� w�t ' i� compliance with all app4icable laws regulating constructi�n, zoning and lartd developmertt. A�p¢�ati+ott is
<br /> her � made to obtain a permit to do work and instailation as indicated. I certrfy lt�at no +,�rk � in�+ has
<br /> � prior to issuance of a permit and that all work will be per�omied to meet stand�ds of aN la�as r�g�lating
<br /> f� 'on, County and Cify codes, zoning regulations, and land devefopmeni regulatiorTS in the juri�. ± akso
<br /> � cert�y ihat 1 understand that the regulations of other govemment agencies may appiy to the inten�4ed aro�rkk, �f tt►at it ss
<br /> my responsibility to identify what actions I must take to be in corr�pliance. Such agencies inc�t�de but are rx�t 1� to:
<br /> - Departrn�t of Environmental Protection-Cypress Bayheads, We#land Are.as and En+�� Sensitive
<br /> Lands, WatedWastewater Treafinent.
<br /> - Southwest Florida Water Management District-Wells, Cypress 8ayheads, Wetiarrd A� �
<br /> Watercaurses.
<br /> - Army Carps of Engineers-Seawalls, Docks, Navigable Waterrways.
<br /> - Department of Health & Rehabilitative Services/Environmental Heafth Uni�-Welis, Was#ewa#er���t,
<br /> Septic Tanks.
<br /> - US Ernrirvrxnerrtal Pm�ection Agency-Asbestos abatement.
<br /> - Faderal �4viaiion Authority-Runways.
<br /> I ur�derstand that the tdiowing restrictions apply to the use of fiq:
<br /> - Use of fill is not allowed in Flood Zone "V" unless expressly parmitted.
<br /> - If the ftll material is to be used in Flood Zone "A°, it is understood thai a drainage p�n � a
<br /> `compensating volume" will be submitted at time of permitting which is prepareci by a�ro�r� �
<br /> }icensed by tl�e State of Florida.
<br /> - lf the fi!I material is to be used in Flood Zone "A" in connection with a pe� buiidir�g using � ara�
<br /> construction, I certify that fill wil! be used only to fiil the area within tt�e stem w�i.
<br /> - If fi(I material is to be used in any area, 1 certify that use of such fiH w� r�tst adMefse�,r
<br /> `' properties. If use of fifl is found to adversely affect adjacent Rrupen�es, the �� may be d�ec4
<br /> '` the conditions of the buildin ermit issued under the attached ,'{�)
<br /> 9 P perm�t app�Ca�an, for t� less
<br /> ' acxe wtrich are elevated by fill, an enginesred drainage p3an is required.
<br /> If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owrier of ti�e pe�ng � set #� �n
<br /> ` this �Ciavit prior to c�mmencing construction. I understand that a separate permi# may be required i�r �a} wxu#c,
<br /> piu�g, signs, welis, pools, air condi�oning, gas, or other installations not specifica�y �rtdud�d �n t�e �. �
<br /> peRrrit �ssued shall be cortstrued to be a license to proceed with the work and nat as autho�rity to v�la�e, can�, �, af
<br /> set aside any provisians of the technical codes, nor shall issuance of a permit prev�►t the 8u�irtg U� ��
<br /> requiring a correction of errors in pfans, construction or violations of any codes. Ev�r}r permi# �ssued sha� bec�e �rnra�id
<br /> unless the work authorized by such permit is commenced within six months of pefmit i�e, or if woric �u�ed t�y
<br /> the permit is suspended or abandoned for a periad of six (6) months after the #ime the wo�lc �s �c�ed. A�e e�d�i�x►
<br /> may be requested, in writing, from the Bui(ding Official for a period not to exceed ninefy (9E3j � anc# y�kl de�s��ra#e
<br /> justifiable cause for the extension. If work ceases for ninety (90) consecutive days, #he jt� is �
<br /> ab�
<br /> WARNlNG TO OWNER: YOUR FAILURE TO RECORD A NOTfCE flF COM�f��EAiT MAY �L� IMi '10pl�tR
<br /> PAYING TWICE FOR IMPROV TS TO YOUR PROPfRTY. 1F YQU INTEMD Tt} FNiIINpNG,� C�#lT
<br /> WITH YOUR LENDER O BEFORE REC RDING YQUR NO'tiCE
<br /> FLORIDA JURAT (F.S. 117.03)
<br /> OWNEit OR AGENT - CONTRACTOR
<br /> Subscribed and swom to (or affirmed) ore me this Subscribed and swom to (or aff rb me �is
<br /> "1-2,C���1 by �oNN t�VEL.�( �( Zd• It by_ Ta H 4 ,�
<br /> V�(b,Q,Zs/� person� ally known to me or has/have produced Who is/� �ersortaNy knov�m to rne or i�1Fra�e pr+oduoed "�,
<br /> r
<br /> as idenUfication. '—°" � �
<br /> � .
<br /> Notary Public
<br /> Commissipn No. � � cx-��--� Commission No. �� _(p
<br /> ik .
<br /> �', Name Of ota ed, rinted or stam�ed _ Name of Notary typed, prirrted or stam{�C!
<br /> •t��:"^�,, KRISTEN P. JOSEPH
<br /> = ��� � Commission # DD 881627 ".,�"„
<br /> ,�M::r�,,,, KRISTEN P. JOSEPH
<br /> �;.,��a: Expires April 21, 2013 *; ;= Commission # DD 882627
<br /> -�,,p ����`'� �n�ear�� y Fa��� in�urenceac assao�y ��N`; EXpif2s Apfil 21, 2013
<br /> � f c1. '' ` : �ndedT' faminsu�ance80 385-7018
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