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t��RF�iI� �PRLICATFC?K <br /> � - <br /> llTILITIE� LOCATE CONFIRMATIQf� htUMBEF�: <br /> (�RO�IDE �KETCFt Ih! THIS Af�.E�t, IF QDDITIQN�iL S�AGE t5 REQUZRED, AT�l�C:H TO 1`HI� <br /> APPLYCATIOh. <br /> i <br /> J� �)L ��� I�iVe r�UZ (S c:���) �J 1�t�s � <br /> L1c�T S t RT1�� <br /> � til <br /> Nt7'T'To F�C�EE�?lc�oss oPE. <br /> CoNTRAMc+R �l4�(.L .�CJ't�' <br /> " � �} � Q�� (�EMOVE EXtSTiN(� �tO�W4C <br /> � <br /> A�D D�s Pos�� P�2n Pe7ec� <br /> S � e �,�, Lk' <br /> � 3�k "7' F't-�4Rt�5� �Tµ � <br /> ' St D� <br /> SAWCUT IFSPiEl�IT �fl I�JS�FCC <br /> � _ �r i(�ER EX?h�J.C70� 1'o t�U7s, <br /> RFFIDAVIT• Application is hereby made to obtain a permit to do work and instailations as indicated. I certify��hat ail foregoing <br /> information is accurate and that all work will comply with all applicable codes. I understand these codes shall take precedence over all <br /> approved construQion dacuments, and issuance of this permit is verification that I will notify the properry cwner of Florida Lien t�aw <br /> req,, F.S 713. <br /> The issuance of this permit does not ensure compliance with deed restrirtions and I understand that additionai deed <br /> restrictions may apply to this property. <br /> �[( �rark sha{t c�n�piY v�r�t� tt�e ccrrr�nt Florida Building Code, Fub(ic Y�arks Design �Sanu:af and FDOT Desigr� <br /> �tan�arc4� (if ap�E�eable). (Public Works Design Manual online link; www ci.zephyrhills.fl,us/pubiic_works.asp) <br /> APPLICATI01� iS VOID UI�LESS SIGf�ED WITF�t PROPER IDEf�TIFICATION AND WIThlESSED BY A PERMIT <br /> TECHNICIAN OR NOTARY PUBLIC. <br /> hiQTE: 7he Git�af��phyrhiiis is nat respansibie far maintenanc�ar repairs of driveways. 6riveMrays shafE not alter/ <br /> interfere vtrith exi�ting stormwater treatment and J ar canveyanc�. <br /> PROPERTY OWNERS: By signing this application: I certify that I �ve read and understand the ow�7er/builder disclosure <br /> statement. (piease initial) �'" <br /> Larry B.Morris ��---"°'��� P �"� 8-12-20�3 <br /> Applicant Pnnt Name Appli�aa�Si a re Qate <br /> _�.(/Z.CN� 8-12-203 <br /> Permit Technician Signature (or) Notary Signature Date <br /> Applicant is(X) personally known to me or prod�ced as identification. <br /> (type of identification) <br /> SARA L.BIRCH <br /> o'!.�x'�fc <br /> P a g� � 6 f 3 =: `� �'COMMISSION#tEE838046 <br /> IXPIRES:SEP 24,2016 <br /> �"`� Bonded mrouph 1 st State Insurance <br />