I�IOTiG� Or t7��D RCSTPICTIOt�IS: Tf��.und�rsigncd undersfi�ncfs�Ll�at�Lhis p�rmii m�y!�c subject fio "cio�cC'resfirictions"
<br /> which may f�� mare r�strictiv�i:h�n Counfiy rec�L�I�ttons. TI» �mdersign�d �ssumes r�sponsibiiity•For compliance wiCl� any
<br /> �p�lic7ble deed resfirictions.
<br /> UIV�.tC�IVS�J7 C�NT.�ACTOi�S AND GONTRAGTC►t-2. I��SPONSIB(LITIC�: I�r �the owner ha5 iiir�cl � canfiractar or
<br /> canfir�ctars�o uncler[alce work, �hoy m�y 1�� recJuired•[o b� Iic�nseci in ��cordance with st�t� �nc( locaf r�gulafions. If�i7e
<br /> eanfir�cfior is nofi Iicens�d �s rec�uir�d i�y l�tw, ho�t1� �the owner ar�cl con�r�clor may��ie cil•ed �For � misd�m�anor violafiian
<br /> under st�te f�w. i�F�h� own�r or intend�d canfr�c[or �re unc�rt�in �s �lo whafi Iicensing r�quir�m�nis in�y apply�Tor fi�e
<br /> intencl�d worlc,�11�y�re aclvis��d to�cont�ct th� !'asca County Builciing Inspection Division—Lic�nsing Secfiian af 727-5�1•7-
<br /> 80�9. 1=ur[h�rmore, iT �ti�e owner h�s hired � contractar �r aoni:ractors, I�e is �dvis�.d �[a h�vc tl�e conir�c(or(s) slgn
<br /> � �artions o•F'the °contractor l31oc1<" o�f 1:1-�is �pplic�l'san �Far wliicI� [h�y wi1l be res�onsil�Iey .I�('you, as �tl�e owner sign �s ti�e
<br /> confirac[or, fii7�fi m�y i�c an in�iica�tion fih�t 1�e is riot prop�rfy iic�ns�d �ncf is no� �n�ti�tlecf �lo permi�ting privi{egos in I�asco
<br /> cocrnty. .
<br /> ?RANSI�aRTATION IIIIIP.ACTIUTILITI�S IIIlIPI-�CT A�(I� PCSDUI�CC PCCOVCI��'1=�GS: Th� undersigned underst��7ds
<br /> ti�at Transpor[�fion fmp�ct C=�es ancl Recourse l��cov�ry Fees m�y apply�:a fil�e consti•uction'a�T n�vv builclings, ci��nc�e �C
<br /> us� in �xis(in� bti�lclings, or �xpansion o��Qxis{inc� I�LQidings, �s sp�ci��ied ii� P�tsca Co�tnty Orciin�nca numb�r 8�J-07 �nd
<br /> �0-�7, as �mencio�L The uncicrsign�d �isa uncicrstands, �;h�t such �F��s, �s m�y I�c duc, will b�-icien�l•ifiec! �t ihQ filme o�f
<br /> p�rmitfifn�. It is fiurti�er uncicrsfiaoci th�C Tr�nsporL•��tion ImpacC 1=�es �nci R�sourc� l�.ecavory 1=��s musfi be paid prior fio
<br /> receivinc� � "eertiCc�ti� o�F occu�anncy" or�Fina1 power reie�s�. if.�th� �roject does nat invoiv� � c�r['rCe�te o�f oeeup�ney�r
<br /> •Fina1 �owor r�ieas��, ti�e�rees must f�� p�id prior�to p�rmii issE«nc�. Furfil��rmore, i•f n�sco Gounty WaterlSewer Imp�cfi
<br /> 'fees�re due,fil��y must I�E p�ic(prior�L•o �ermifi issunnce in �ccord�nec witt� 7ppiic7ble Pasco County ordinances.
<br /> COIVSTIitJCTION I�I�N J�I�W�Gh���ter 7�13, I=tarid�5t��;utes, as �m�ncied); )�F va(u�tion o�f wor}c is ;�2,500.00 or mar�, !
<br /> a�rti�(y fii��t 1, th� �pp{icanC, h�v� ►��e��r proviclecl wiL1� � eo�y o�F lI�� "�'Iarid� Canstrucfiion Lien Law—I-Iomeowner's
<br /> 1'rofiec(Ion Cuicle" �repareci by•[h� 1=lorid� D�nar[m�n�t o•r Agricuiture �nci Consum�r A�Fzi�-s. hF th� �p�iic�nt is som�one
<br /> oti��r fihan ti�e"owner", f certify fii��t ( 11�vc.obfi�in�d � copy o•f�l•1��abovc d�s�ribed dQCUm�ni�nc! promise in good•��i{I�fio
<br /> cleliv�r il to tl��"owner"prior�Lo commencemenfi. _
<br /> CONTl�AGTOP'S10WNCt�'S ArI=iI�AVIT. i c�rti�Fy i:h��t�li�lhe in�Corm�tion in this appiic�tion is �ecurate and �hafi al!v+rarlc
<br /> wiff f�e done in compliancc wifh �Il ��plic�I�l� l�ws regul��ting c�ns•Lrucfiion, zaning �nd iancl ctevelopmen�t. Appiica[ion is
<br /> lzer�by m�de to ot�[�in a �ermit fo do worlc �nci instalia[ion �s incfic�fi�cl. i eertify •ki��L no woric or insfailation f�as
<br /> commenceci prior to •issu�nce o�f � �Sermit �nd �ti��t �II woric will b� �crf�rmec! �o m��fi st�ndards o�f al! Iaws regulatinc�
<br /> canstruction, County �nd Ciiy cocies, zoning r�c�uIations, �nci Iand d�vetopment regui�tions in fii1� juris�iictfon. i afso
<br /> , cortiCy thafi I und�rstanci fil�afi fii�� r�guini:ions o�F o�th�r gov�rnment �genci�s may ��ply fio fil�� ini�nded worlc, a��c! tl1�fi ifi is
<br /> my rosponsibifity ta identify wh�t�cGians 1 mus�l i�lc�to be in compIi�nc�, Such ag�ncios Include but�r�not limified to:
<br /> -- Dep�r[menl o�(Cnvironmentai�1'rotacCian-Cypr�ss 13�y1���tds, Vtf��[i�nc{ Are�s �nd Cnviranmenfaliy S�nsitive
<br /> Lands,lN�t�rlWas{�w��[�r Trea{ment.
<br /> - 50LitIlWGS� C=lorid� Vl/���r M�nag�menfi Disfiriefi-W�IIs, Cypr�ss 13�y1»acis, W�ti�nci Are�s, Alfiering
<br /> 1N�fi�CCOUCS�s.
<br /> - Army Corps o�T Engine�rs-S��waHs, Docics, N�vigabl�W�ti:erw�ys.
<br /> - D�p�rlri»n1: o�f !-leal�l� & l��I�abiiifiai:iv� ServiaeslEnvironmenl�i i-lealti� Unit-Vltelis, V1/�stew���r Tr�atm�nt,
<br /> Septic Tanlcs.
<br /> - US Cnvironment�i Protec�:ion Ag�ncy-Asb�s�[os �f��fiemenfi.
<br /> - i=ed�r�1 Aviafiion Authori�[y-Runw�ys. �
<br /> I underst�nct ti��fi fih�following r�sirictions appiy�ta��ti�e us�o�f�fill:
<br /> i y Us�o�F�Fill is not�tllaw�c( in Flooc(Zone"V"un[ess �x�r�ssIy permii:t�d.
<br /> I�C �[I�e •Fill m�fieri�l is to 1�e usecl in C=faocl Zone "A", i� is understooel �t1�aG• a c{r�in�go �i�n �ddressing a
<br /> "comp�nsafiinc� vofume" wili be submltted afi iimc o•f p�rmitling whicI� is �repar�d Iay a �roFession�i on,�ineer
<br /> (ic�ns�d by tl��S��t�a•f I=lorid�. • .
<br /> - i�F{I�e �(i11 m�fi�ri�i is fo be•usec( in 1=looci Zonc "A" in connec�ion v+�ith a p�rmiLfi�cl Uuilding usinc� sfiem wa!(
<br /> ' constr��ctian, I c�rCify�t11�[�fill wil! ta� used�onIy�La�fi[I fihc�rea wifihin the sfi�m wa11.
<br /> - l�f.fiiil ma[cri�I is �Lo i�e useci in �tny �re�, f�cerfi�Fy tha�; tts� o�f such 'fiH will nofi adv�rs�ly a•[f�ct adj�aent
<br /> ' properti�s. ff.�tis� oi��riff is:faurid �ta �dvers�ly ��ff�cfi �clj�cenl prop�rfiies, �the own�r m�y t�e cifiod•For vial�tinc�
<br /> fl�� canclitions o•f 1:1�� building pelmiL• issuoci•under�[he �fi[�acii�d pe�mit �ppfic�tion, �For iots less tl�an on� ('�)
<br /> acre wl�ich�r� �tev�i�ci t�y�tiii, �n �ngin�cr�ci dr�in�g� pf�n is reqt{tred.
<br /> i��t am th�AG��IT rOP TI-I� OV1tNC-1�, f promis� in good�Fnith ta in�form fihe owner o�Tthc p�rmitfiing condi�ions s�t��arth in
<br /> tl�is afFPclavi( �rior to commencing consfiructian. 1 unci�rs�[�nc1�h�t a sep�r�te p�rmifi m�y ue r�quir�d �for�lecfirlc�l worlt,
<br /> �I��mi�in�, signs, w�11s, poais, air conditioning, g�ts, or oLh�r ins�[�llafiians not�specifiically inclur�ed in �ti�e applicafion. A
<br /> �ermit issued shal! hc consiruecl to I�e � Iicens�fio prace�d witl� ti�o woric�hd not as �trll�ori�y fio,vio(�le, c�rrc�i, �4tor, ar
<br /> seG�sicle �ny provisions o•r fit��fi�ci�nicaf cocles, nor shaii issuanc� o�F� permik pr�v�n�t�LIZ� IIuilding DCficia(�From fil�ere��rL�r
<br /> roquiring� corr�ction o�F�rrars in �lans, consiruction or via(afiians a�F�ny codes. Cvcry permit isst►�d si�ali i�ecarr►a inv�lid
<br /> unl�ss fil�� worlc�«thorized by s�ich.permit is cammerrceci wifi�in six mon�li�s a�r p�rmf� issu�nce, or if worlc aufihorIz�c4 by
<br /> fihe permi[is sus�ondeci or�f�ancianed���or� ��riocl ofi six(C�) manfihs ��f-Ler i:l��iime�Lhe warlc is comm�neect. An ext�nston
<br /> m�y be rQq�«st�c4, in v�ritIng, �from th� Builrling'Ofilici�t ��or � �eriocl no(��o �xc�ed ninet�y (90) d�ys �rtd wiii ci�monsfr�ie
<br /> 1�RS!•Ifii�I�I�cnus�•1'or•[h� �xt�nsion. i�f worl<ce�s�s�For nincty, (90) consecu�live d�tys,fil��jo1� is consid�red�U�ndoned.
<br /> WARNINi� TO OW1VLr: YOUI�.i=.l�IL.UI�� TO PC�OI�D ,�1. NOTiC� OI' GOl1t1iVI�NG�3UI�NT MA�" I��SUL.T IN.Y�I.(P
<br /> PAYtNC TWIC�1=0t�tMt'I�.C7V�NtCNTS TO YOUC-�.PI�.OP�R`!"`f. Ir YOI'J II�IT�ND TO C]I3T,�,IN T=IN.+�.NGING, CONSULT
<br /> WaTt-r YoUP L.CN�G�o�.AN ATTOt�NCY BCI�ot��P�coRDti��Y'atJR NoTi�� 01= coMM�NC�MCN`C.
<br /> rl.ORIDA JURAT(t=:5.1�f 7.03) � ,
<br /> OUVNCR OR A�CNT C`_5��'���-- �YYw�l�U.jfl GONTfil�1CTOP� ��""'�-�''� ��'+-�
<br /> uUscriUeci and swom to(or af irmad)b;�a rer�e�fhis Subscribed,y�nd sworn fo r afiF�mect) fo�ro,m o�is ,
<br /> —eZ—I by Cl'�c/6 .tLt/{�v i l�'—cZ/Y lay � �G �/'�fltl/)
<br /> Wl7o is/aro person��, !I�wn Lo mo or i�as/Jiavo roduceri Who is/�re person�ily t<nown to m�or has/have produced
<br /> as Idonti[ic�iion. �s ldenti�icatton.
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<br /> .�fis 7,vz���c,� Notary PuGlic G Nofary Public•
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<br /> Commissson No. Commission No.
<br /> UBLIC•STATE 4F kZ,ORIll� NOTARY PL'ELIC-STATE OF FLORIDA
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<br /> � Nam�o(Nalary typed,prin[�cl or s[ae�� •
<br /> Rlame of Nolary typed,p�(n�' .�r�ampor�sion�EEp44SQ4 'Camni?s;�ion#EE044504
<br /> ""-•. ,,�`Exp�res. :�OV.22,2014 �'�.,,,,,,��Expir�� �OV.22,2014
<br /> BO;v�EDTFiF,C:,7L.;tifICBO\�L'r'GCO.,ItQC. $4\TlEDTHRi:i7:.�;:30\�r;GC4.aINC.
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