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. .�.� <br /> . t <br /> NOTECC OF DC�D RCSTRIGTI�t�ls: The.uncfersic�ned unc(�rst�ncis fit�at�[his permit m�y 1�� subj�ct�[o"cf��ci"resfihiefiions"} ; <br /> wiiicii m�y i�e more resfrictiv��ll��n Ca�infiy r�c�L�l�tians. Th� �mdersigned assum�s r�sponsibilily•�or compliance with �ny <br /> appiic�iale d��d resfirictions. � <br /> UN�.IC�NSCD GO�iTI'tiA.CTORS AND CONTRACTCIP I�.CS�'O�SIQCL�ITIES: (f �Lh� awn�r lias ilirec! � contractor or ; <br /> con�r�clors to uncl�rla!<e worlc, �h�y may la� r�quirec(fio bo 1ic�nseci in �ccordanc�uvith st�t� �nd loc�i r�c�L�fations, i�F tl�e � <br /> cantrac{or is nofi licens�d �ts required by lzw, I�o�lh �l�e owncr ancl confir�ctor m�y'be ciied �ror � misd�mearior vioiation ! <br /> under stafi� iaw. i��tii� awn�r or infenciec� canfr�ciar �re unc�rC�in �s fia wh�� fic�nsing r�quirem�Ms �n�y apply�for ih� � <br /> intenclec(woric,i:hey�r� advis�ed to�cont�tet t1�e l��sco County Bttifciing tnsp�ci:ion Division—Lic�nsinc�S�ctian �t 727�g4.7- , <br /> 800�J. 1=+.�rlhormore, if ihe owner has hir�d � can[ractor or contr�c�;or.s, hca is �dvise,d fo i��v� ti�� coMracfior(s) sic�n ' <br /> portians o�F'fihe "conir�ctor [3lacic" ofi fihis �pplfca�[ion •for wl�icl� lhey wi(1 1�� responsibie, .if you, as �th� owner sic�n as tiie <br /> contr�ctar, fil�at m�y bc �tn indic�lion i:ha1: he is rioi praperly licensec! �nc( is not �i`�ti�(lec! l'o p�rmi#:Ling privilegos in Pasco <br /> Cotmty. ' . <br /> TI�ANSI'ORTATtON iMPACTILITILITICS IMI'.ACT AND PCSOUPCC I�.�COVCPY�F��S: Th� unci�rsigned underst�►u!s � <br /> tl7a[Transpori��fion Imp�ct C'ees �nd R�cours� I�ecovery F�es m�y�ppiy to i:he consiruciian`a��n�w fauifcffnc�s, ch�tnge oF <br /> tis� in oxisling buildings, or exp�tnsion o�f existin� I�uiidings, �s sp�ci�(i�ci in l�asco County Ordin�nco numi��r 8�-07 �nd � <br /> 90-07, as nm�nd�cl. Th� �tndGt'sIgned aIso undcrslands, �th�t such �Cees, �s m�y (�� ciue, wili 1�� identi�ied nfi fh��[ime o�F , ; <br /> p�rmitting. It is �'�trther uncicrsfiooci ti��l Tr�nsporL��ion Imp�tcl 1=��s �nc1 I�,esource C-�.ecovery F��s must be paid J�rlar ta I <br /> recoivinc� n "certiFic�fie o��occup�ncy" or�Fin�i pow�r rc►ease. 1•�fihe p2'aj�c{ dc�es noi involv� �r c�rEl�fic�t� a�f accupancy or ; <br /> •fin�! powor rele�s�, 1:h��re�s ir�ust b� p�id prior fio permit issu�nc�. t=urti�ermar�, i�F 1��sca Cotrnty W�ter/Sew�r fmp�ct ; <br /> •Fe�s ar�due,fih�y must be p�ic! prior�Co•p�rmii issu�nce in accardance wifh ��piic�i�i�P�sco Counfiy ordin�nces. <br /> CONSTRUGT1011i �iCN L.A1f11(Gh��L•ei�7�t�, 1�Ioricla 5tattrt�s, as �m�ncl�c1�: I�Fva1u�tion o�f worlc is ;�2,500.00 ar more, I � <br /> c�rti�y tiiat i, ti�� appficant, h�v� h�en provid�d wiGl� a capy o•C �lhe "F1Qrid� Construction l.i�n l�av�r—l-lomeowner's <br /> Protection G��ici�" �r�p7r�ci i�y�ti�� 1=larid� D��ari:m�nt o�F AgricL�llurc �tncf Consttm�r A�Ff�irs, l�f i!» �ppllc�nfi is som�one � <br /> oih�r 1:h�n ihe `bwner", I cerLify fihafi I 17�vo.oi�fi�ined a copy o���tl�� �bovc descrii�ed documenfi�nci promise in good•faitl�to � <br /> c{eliv�r it to the"owner"�rior i�o comm�ncemenC. <br /> GaNTRAGTOR'SlOINNCP'S AF1=il�AV1T: ( certi�y�h��l•al! �Ll�� in�formation in fil�is applicatIon is �ccur�fie and ihat ail worlc ! <br /> wiii i�c done in compiiance with aff ��piic�ble l�ws regul�ling eons�ruci:ion, zoning �nd lancl ci�v�lopmenl. A�plic�tion is � <br /> her�Uy m�de fio obG�iin � p�rmit fio da waric �nd inst�iiation �s indic�t�d. 1 c�rfi�y �Lh�t no woric or insfaif�tion l��s ; <br /> commenc�d nrior fio Issu�nc� o�( � p�rmit �nd �tti�fi afi wori< wiil i�e perrorm�ci to m��t sfi�nci�rds o�F aii iaws r�guiating � <br /> cansirucfiian, Co��ttiy 7nc! Ci1y eod�s, zoni�7g r�c�ul�fiions, �ncl Jand development regui�fiions in fi1�e juriscifcfiian. f aiso � <br /> a <br /> e�rtify that i unclersi�ncl�h�f [I�� r�gul�tions o��other government �gencl�s m�y apply i:o fihe infi�nd�d worlc, �ncl fih�l it is � <br /> my responsiUi(ity fio icienfiiFy wi��t�cCions i mus�t�ic�fo b�in com�ali�nc�. S�[c!� agenci�s includa but�re not limit�d to: i <br /> - ''`�.°'';.D,�p7rCmenfi o�F•Environm�nfi�1 �Prot�ction-Cypress i3�yh��ds, W��tl�nd Are�s �nd Cnviranmenialfy S�nsillve � <br /> L'alicls,W�terNi/astewater Tre�tm�nt. <br /> - 5authwest Floricla Vlfzfi�r Managem�nfi bis�iricfi-We![s, Cypress B�y1�e�tds, W�tl�nd Aro�s, Alfi�ring j <br /> W�fi�rco�.trses. <br /> - Army Corps a�F Cngin�ers-Se�w�iis, Docics, Navigabl�W�t�rways. i <br /> - Qe��rtri�enfi o�� I-1e�lth & Rei�abiiita{iv� Servic�s/Cnvir.onmentai (-fienffii� Unit-Vl/eifs, Vtl�tsfiew�ter Tre�fiment, ' <br /> S�p�ic Tanlcs, <br /> - t!S �nvironm�ntai I�rat�ction Ag��cy-Asb�s�:os ab��t�m�nt, j <br /> - 1=�der�i Aviation Aufihority�Rttnw�ys. ' , I <br /> ! uncl�rsfi�nd ih�t fihe fo(lawing r�strictions a�piy�to��the us� o�r��iii:' <br /> - Use af'fi!! is not allav�r�d iri I=IoQC(Zone"V"unloss exprassiy p�rmitfied. , ! � <br /> - I�f (he �fil! m�t�ri�1 is 1:a b� used in 1=laocl Zonc "A", it is undersiood (hat• a c(rain�ge n1�n �ddr�ssin� � � <br /> "comnensafing volume" wiil b� st�bmilfed a1: iimG a�f permitCing wl�icl� is �arcp�red by � prof�ssion�l engineer � <br /> (ic�nsed Uy i:i�e S[�te o�T F(orici�. • . � <br /> - lfi th� •fiil m�teri�l is Co b�-us�d in Fiood Zor�� "A" in connaction virith � permitfiecl GtTflding using stetrz wal! , <br /> ' consir��cl:ion, ( cerCi�Cy fih�fi•(il1 wi]! b� us�d•only fio•li(1 th� �r�a wifii�in fii�e stem w�i1. ; � <br /> - if..'iifl material is �a 1�� us�c{ in �tny �r��, !•cerLi�fy �L•hal us� a•T suc1� �[i1( wi1( no[ �dv�rsefy a•��ect adj�cent ; <br /> ' properli�s. ir.�us� o�`�Fiff is :�ourid to �dvcrseiy��fi�ec[�dj�c�nt nrop�rti�s, �f�t� own�r m�y be cited �Tor viol�fiing <br /> th� conditions o��t1�e Uuilciing permit issuad ua�ci�r•the �tfiacf��d permit app(ic�tlon, �for lo[s less f(zan an� (�) � <br /> �cr�whicl� �re elev�fied I�y�ri1(, an engin�ered drainage plan is reqt�ir�d. � I <br /> (�F f am ihe AGCNT F�P 7I-IC QWN�P, 1 Jaromis� in gaod�C�it1�1:o in��orm�L1ie owncr a�rihe p�rmitting candifiions sefi�Forti� in <br /> fi�is af�ici�vifi �rior to comm�ncing consfirucfiion. 1 und�rsC�nd th�l• a sep�r�fi� permifi m�y Ue r�quir�d��or eiectric�i wortc, ! <br /> plumhing, signs, weiis, poois, �ir conciifiioninc�, g�s, or aLher insiall�+fiians not�sJ�ec�fica!]y included in ih� applic�tion. A � <br /> ��rmit issued s1»i( he consfirueci fio b� � 1ic�ns�fo proc�ed witi� the woric�ncl not�s ���iilority to,uiol�fi�, cancel, �lfi�r, or ; <br /> set�sicl�any�rovisions o�F t1�e fi�chnicat cocies, nor shaii issu�nce o�T� p�rmit pr�vent�t•I�� C�uilding O�fici�i��rom iher��fC�r ; <br /> roqti�irinc� � carr�ctlon o�f�rrors in �al�ns, cansirucfiion or viol�iions o�F�ny codes. Cvcry�ermi[isstieci s1��1f becam� inv�iici � <br /> uniQSS fih�wor4c�ufhoriz�d by sucl� {��rmit is commencec! wi�hin six moi7�Lhs of�ermiL issu�nc�, or i�F wor(c aufii�orized by ; <br /> fihe permit is sus�on�Ied or ab�ndoned°For a p�rioci a�six(�) moM11s �•C�:er ihe �ime�[h�worlc is commenced. Ai� exlension � <br /> may be requ�sted, in wrifiing, ��rom fihe Builciing'O�P�icial ��ar � periocl not fio �xc��d nin�ty (94) d�ys and wil{ d�monstr�te � <br /> justlfinble cause�for�LI�e ext�nsion. I�f worlt ce�s�s�For ninc�y. (90} cons�culi�e ci�ys,i;i��joi� is consic(ored abanclon�ci. , <br /> WARNINC TO OWNCr: YOUI�.C.taELUI�� TO I���nPD .Z1. NC�TICC OI= �OMM�NC�M�NT M�l`�° I��SULT IT�•Yt3UP � <br /> PAY[�IC TWIC�FOI�IMt'I�.t}V�IUICNT�TC3 YOUI�f'I�CIP�i�TY'. I�Y(��J INT�ND TQ ORTAIN t'IN.+�,NG1N�, CONSUL.T I <br /> WiTI-T YOUR I.CND�P OR AN I�.TTC7l�NCY 13�T"CtR� I�CCORDINC YOCJ.R N071�� OI= COMMGNG�MrNT. , <br /> r-�.or�i�a�ur�,�-r{r-:s.��7.o3a - _ _ <br /> _����� .-� �_����- � <br /> OWNCR ORA�CNT,��'��;�� Ct�RfTC,ACTOi� ��1� — � <br /> SuUscribed nd sworn�p�or nffirmed bejo re this 5ubsci'ibed anci sworrt to or�ffrmed (�Coro e ll�is . � <br /> /el-3-/ 6y ►Il u,/t�CU+ cl�d'�� !a2-.3/�/ (�y k1.��/ZG'r,� ��1 L'O�' i <br /> Who is/arc�nerson�(�y icnown Eo m�or iias/r,�rTm��r�s, Who Cs/ar�p�rsonally Icnown to me or has/have�roelueed i <br /> /�-� as identi(ic�iiott. ��� as identiiica(Ion. i <br /> ' ' � <br /> Noiary i'uUlic • Nofary nul�lia� ` <br /> . � <br /> Commission No, Gamr 'ssi No. � <br /> , { , <br /> t�,•..� ; <br /> t�lameof ot�t���..� c�orsamp. (Va ebfA�al�Y '���'!'����j��lG � <br /> :�° G�:.��i�C1E LYNN HARTWIG =.�. ' MY CQMM1SSroN#FFas4es� ' <br /> -# = MYCOMMISSION#FF084897 :�y�:�PA , <br /> '- "•;F',o��oQ:�•� EXPlRES fJatober 27 <br /> <�� '�°� ,2017 � <br /> ''.'��oF�;?Q,�' EXP(RES October 21,2017 (�o� ��g'�id� Fi�ridqNota BANIce.c�,m . <br /> (407)3s8-o153 FloridallotarySeroice.com , <br /> I <br />