HomeMy WebLinkAboutBuilding Permit Application PERMISSION FROM OWNER OF PROPERTY
DATE: ON.
AS OWNER OF THE FOLLOWING DESCRIBED PROPERTY,I AUTHORIZE e/—L
TO HOLD A/TpEMPORAR USE EVENT.
PROPERTY TAX IDENTIFICATION#:
LEGAL DESCRIPTION OF PROPERTY: !�
PROPERTY ADDRESS: 336&
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OWNER INFORMATION:
PROPERTY OWNER'S NAME: CIGI(IP /IJLff '�
PROPERTY OWNE ADDRESS:
CITY: t STATE: C ZIP CODE: !!
K-cu-11
t-7 to;>
PRINT OWNER'S NAME SIGNAT O ER
STATE OF FLORIDA,COUNTY OF < f Lt,.0 -e-
ACKNOWLEDGED BEFORE ME THIS 13 DAY OF CXt ,20A7-1
BY �n-p-L WHO IS PERSONALLY KNOWN TO ME
0jj WHO HAS PRODUCED AS IDENTIFICATION.
GNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
TITLE: NOTARY PUBLIC COMMISSION NUMBER: �Z.SOI
cm o
's• �j mf Go 125931 seal
l�S:Mi 14.2021
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SLMS 10/191215