HomeMy WebLinkAboutZoning Compliance/Use Permit r
OFFICE USE ONLY: D VTF.MED: r+'
Cost: $55.00
PLANNING&DEVELOPMENT SERVICES
BUILDING.&CODE REGULATIONSS'IDIVISION
" 2300 Virginia Avenue
• , , Ft.Pierce,FL 34982-5652
- - - 772-462-1553 Fax 772-462=1578
A-PPLICATION POR TEMPORARY USE PERMIT
BUSLNESS NAME: Alternative MC
NAME OF EVENT: Alt.emative Annual
]LOCATION AND ADDRESS:OF TEMPORY'VSE,EV N T• �f 1
6964 Heritage Drive A2 Cn A�: `�.}. � T •�,yr.
PROPERTY TAX IDENTIFICATION#: 034) 7
DESCRIPTION OF TOMPORARY.USE:
Party to raise money for Near Horizon
F` DATES OF THE EVENT: June 24th 12pm 4pm
APPLICANT'S NAME: Anthony QiofjrStO
APPLICANT'S STREET ADDRESS: 31108 SE Mali Terrace -2
CITY: .Port St Lucie STATE: FL ZIP CODE; 34984
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WILL THE EVENT HAVE.A TEM PORAR`,'LIQUOR LICENSEa YDS NO xx
N4'ILL.THE EVENT-HAVE A TENT(s):YES—NO XX (up-ti)900 square feet exempt from fire permit)
} WILL THE HAVE BANISERS/PENNAN PS/FLAGS:YES /No xx (.Only I-per 300 linear feet;32 sq It max size)
I HEREBY ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT AND AGREE TO CONFORM TO
ST.LUCIJE COUN'T'Y LAND DEVELOPMENT-CODE,SECTION 8.02.02J
PRINT APPLICANT'S NAME SIGNATURE APPLICANT
STATE OF T LORIbA,COUNTY OF }(,sic+: .
ACKNOWLEDGED BEFOREVIE THIS DAY
BY n Ino t btt the WHO, ERSON.�KNOWN TOME
OR ',VHO HAS PRODUCED AS.IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT,NAME OF NOTARY
TITLE: NOTARYPUBLIC COMMISSION NUMBER:
SLCPDS I� feS
Nicole hon
Commssi n #�FF945187
Expires:November 19,2019
Bonded thru Aaron Notary
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PERMISSION-FROM OWNER OF PROPERn'
DATE: f G U
AS OWNER OF THE FOLLOW NG D.ESCRIBEII PROPERTY;.I:AUTHORIZE AI.te native MC
TO HOLD A TEMPORARY USE-EVENT.-
PROPERTY
SE EVENT.PROPERTY TAX IDENTIFICATION,#: _ 1� D—CC_ /l
r LEGAL DESCRIPTION OF PROPERTY:
Gaul f�+Zg�-
PROPERTY ADDRESS: 6964 Heritage Drive
OWNER INFORMATION:
PROPERTY OWNER'S NAME:
PROPERTY OWNER'S ADDRESS:_ i�° �� �;1-tQ r;11 LlY
CITY: __Nr tAaw STATE: 7-b ZIP CODE:
PRINT OWNZ ER'S NAINIE SIGNA:TU:RROF O.. R
STATEO:F FLORIDA,COI7iV7CY OF
e_
ACKNOWLEDGED BEFORE ME'.THIS DAY OF Vl�' ,20_A,
BY {�I I` c e Ss WHO IS PERSONALLY 10TOWN TO ME
OR:t�IH HAS PRODUCED ASIDENTIFICATION.
IGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
TITLE: NOTARY PUBLIC COMMISSTON NUA2BER: C G-, .I bW03
,•o16gv°Oa4;':, GRACAMARTIN
" t_ Notary Public sba
' a4 Commission GG 107203 .
.;-�.F<�r My Comm.Expires Jun 30.2021
SLCP3DS 101191201S