HomeMy WebLinkAboutRevisions OFFICE USE ONLY:
DATE FILED:�1 L\ ��
PERMIT#
REVISION FEE: rc . 3 RECEIPT# c
PLANNING&DEVELOPMENT SERVICES
BUILDING&CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772)462.1553
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
LOCATION/SITE
ADDRESS
DETAILED DESCRIPTION OF PROJECT
REVISIONS: L
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CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: ST. LUCIE CO CERT.#:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE(DAYTIME): FAX:
OWNER/BUILDER INFORMATION:
NAME: c�
ADDRESS:
CITY: F j STATE: ZIP: 3 09S-
PHONE(DAYTIME:Skx 1 07 S FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE(DAYTIME): FAX:
SLCCC: 9/23/09
Revised 06/30/17
REVISION
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RECEIVED
JUN 0 4 2018
ST. Lucie County, Permitting
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Applicant has been advised NO SbuChM
can be erected within any easement or
right of way un h i pxoved.
Appilu t IN
RECEIVED
JUN 04 209
ST. Lucie County, Permitting
ED
3i8SAINT LUCIE COUNTY PROPERTY APPRAISER
Perm tREQUEST FOR REAL PROPERTY SPLIT/COMBINATION
Notice: While the Saint Lucie County Property Appraiser's office makes every effort to maintain the most current and accurate information
possible, there are no warranties expressed or implied for our data, its use, or its interpretation. The data maintained by this office is
developed and collected for the purpose of producing a property tax roll and as such should not be relied upon as legal determination of title
and/or boundaries.
BEFORE AN APPLICATION FOR A PARCEL SPLIT/COMBINATION CAN BE ACCEPTED
ALL PREVIOUS/CURRENT TAXES MUST BE PAID IN FULL
(Attach a copy of receipt/bill indicating paid in full)
ACTION REQUESTED: COMBINEQ SPLIT❑ THE FOLLOWING PARCEL(S):
1301-611-0343-000-9 1301-611-0344-000-6
Special Comments or Instructions:
Is parcel vacant?i/\I or improved?L� If improved,indicate location of building(s)
(Identify by parcel &address) 1301-611-0343-000-9( H)/ 1301-611-0344-000-6 (V)
Title must be the same for all parcels being combined.
IN MAKING THIS REQUEST, I RECOGNIZE AND AGREE TO THE FOLLOWING:
1. This action does not nullify or alleviate any existing liens or encumbrances on the properties, and the Property
Appraiser is not responsible for any problems or complications resulting from this action I/we have requested.
2. That this action will be completed by the Property Appraiser's office on a non-priority basis,"first come-first served'.
3. That I/we am/are the owner(s)of record or the legal agent for the owner(s)of record,and that Uwe may be required to
provide recorded proof of such ownership or agency. If acting as agent,written proof of agency is required.
4, That the Property Appraiser is not responsible for errors arising from errors or omissions in surveys or other
information submitted in connection with this request.
5. That I/we have verified with the St. Lucie County Planning Department or other Jurisdictional Agency as to what
adverse effects, if any,this split/combination may have on the property.
6. If the property is mortgaged,I/we must notify all mortgagees associated with the properties listed above.
J ,
SIGMA Owner Date SIGNATURE,Agent Date
-��-
PRINT,Owner PRINT,Agent
Mailing Address, �G�C f 1. ') ,� _ W
Phone: HomeS(__� t Work Fax vV
FOR USE BY PROPERTY APPRAISER'S OFFICE ONLY
Order taken by: Rk C-- A L,5 Date 0�,l' nI '