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Home My WebLink AboutZoning Compliance/Use Permit JPERNII'P#: OFFICE USE ONLY. DATE FILED: Cost: $55.00 PLANNING&DEVELOPMENT SERVICES BUILDING&CODE REGULATIONS DIVISION 2300 Virginia Avenue R.Pierce,FL 34982-5652 772-462-1553 Fax 772-462-1578 APPLICATION FOR TEMPORARY USE PERMIT i BUSINESS NAME: C VY Nt �� VK NAME OF EVENT: /�i'��'%u2 lel l {1f�L�J ell JeA L e dCsL LOCATION AND ADDRESS OF TEMPORY USE EVENT: -7-51scf , ' root s+ ► � FL 3�l PROPERTY TAX IDENTIFICATION M 6W I S-0 (, f 7 0/ 000 DESCRIPTION OF TEMPORARY USE: ' C�u•$S prf (f 1*1 . tM u-� ,Q W19® DATES OF THE EV ENT: APPLICANT'S NAME: jai .4A APPLICANT'S STREET ADDRESS: % 51? A- S CITY: 10'oO¢ S� �ia-G STATE: L ZIP CODE: WILL THE EVENT HAVE A TEMPORARY LIQUOR LICENSE:YES X NO WILL THE EVENT HAVE A TENT(s):YES NO n to 900 square feet exempt from fire permit) � O: � ( P q P P ) WILL THE HAVE BANNERS/PENNANTS/FLAGS?YES /NO (Only 1 per 300 linear feet;32 sq ft mag size) iI HEREBY ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT ND AGREE TO CONFORM TO i ST.LUCIE COUNTY LAND DEVELOPMENT CODE,SECTION 8.02.02J. OA IfI PRINT APPLICANT'S NAME SIGNATURE OF A1,11CANT �x 0 STATE OF FLORIDA,COUNTY OF ACKNOWLEDGED BEFORE ME THIS L2)() DAY I a&4 2011R, —)—e r, By WHO IS PERSbNALLYKNOWN TOME , O i OR WHO HAS*P UCED 1. AS IDENTIFICATION. �. GNATLTRE OF NOTAR E OR PRINT NAME OF NOTARY TITLE: NOTARY PU13LIC COMMISSION NUMBER: SLCPDS 10/19/2015 ,„µY rU IASHAHNA INGRAM ;�� Notary Public-State of Florida . �; My Comm.Expires Dec 20,2018 Commission FF 177249 %SOF F •` Bonded through National Notary Assn. anna` i - I ! 1 � PERNIISSION FROM OWNER OF PROPERTY DATE: t AS OWNER OF THE FOLLOWING DESCRIBED PROPERTY,I AUTHORIZE1-�Atl t✓�N�- AM(Gc�s TO HOLD A TEMPORARY USE EVENT. PROPERTY TAX IDENTIFICATION#: _ — Q LEGAL DESCRIPTION OF PROPERTY: PROPERTY ADDRESS: �S ► ('"+'� ' J L j cu OWNER INFORMATION: /1 PROPERTY OWNER'S NAME: WY,4-)A e, 80 i (d,N` �tm9`�r ova PROPERTY OWNER'S ADDRESS: WOOD S• (.�S ( SrU f e,` cz- j CITY; it° �/4r LJCf STATE: ��— ZIP CODE: 3010 S— PRINT PRINT OWNER'S NAME SI RE OF OWNER STATE OF FLORIDA,COUNTY OF ACKNOWLEDGED BEFORE ME THIS � DAY OF 20`9 , BY Vim- ` �� O IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED. AS IDENTIFICATION. i SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTAR TITLE: NOTARY PUBLIC COMMISSION NUMBER: SUSAN MY COMMISSION#FF 187647 seal =: o EXPIRES:February 23,2019 R °••' Bonded Thor Notary Pcblic Underwriters SLCPDS 10/19f2015 DBPR ABT-6029—Division of Alcoholic Beverages and Tobacco Application for Extension or Amended Sketch of Licensed Premises STATE OF FLORIDA DBPR Form DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ABT-6029 Revised 02/2013 If you have any questions or need assistance in completing this application, please contact the Division of j Alcoholic Beverages & Tobacco's (AB&T)local district office. Please submit your completed application and required fee(s) to your local district office. This application may be submitted by mail, through appointment, or it can be dropped off. A District Office Address and Contact Information Sheet can be found on AB&T's web site at the link provided below. http://www.mvfloridalicense.com/dbpr/abttdistrict offices/licensing.html CHECKTRANSACTION R)=QUESTED Fr,7 Transaction Type: Temporary Extension ❑ Amended Sketch Permanent Extension INFORMATION Licensee (as listed on alcoholic beverage license) Business Name (D/B/A) Cacsa R ' 114tXe aw can R aa froA Location Addres (Street) :1756 S 5 City County State Zip Code 'POr+ Sk I or—te 1 S�. Ce, FL Alcoholicverage License Number Series Type/Class Be 0112- `t cop F Business Telephone Number Email Address (Optional) Z - 21,.Iff ext. FOR TEMPORARY EXTENSIONS ONLY. Date(s) of Extension: 12-o Is i I i G I I ABT District Office Received/Date Stamp 1 I Auth.61A-5.0017 1 TO B,E COMPLETED BY THE ZONING_AUTHOR1TYr GOVERNING YOURBUSINESS LOCATION Ths,secton:on =a lies toga ermanent or tem" ora extension::of,Jicersetl, r`em�ses ,. Location Street Address Ub City County Zip Code Poirk cT Gtr FL S Z Are there outside areas which are contiguous to the premises which are to be prof the premises sought to be licensed?" ZYes ❑ No ❑ The PERMANENT extension of the licensed premises as shown in the sketch complies with zoning requirements for the sale of alcoholic beverages pursuant to this application. 2/The TEMPORARY extension of the licensed premises as shown in the sketch complies with zoning requirements for the sale of alcoholic beverages pursuant to this application. Signed: Title: v 17 e M1P0,rmo Date: �G!g This approval is valid I rts` SECTION"4 HEAI:TH. .z 4s TO BE COMPLETEDF BY THE DIVISION OF HOTELS AND RESTAURANTS COUNTY.HEALTH AUTHORITrY � Xfi The above establishment complies with the requirements of the Florida Sanitary Code. Signed Date I Title i I I I Agency This approval is valid until i Auth.61A-5.0017 2 - sf' y SECTION 5 AFIt}AI/ITOF APIsI~IGANT $ S M , Via: NOTT RIZAT[ON REQUIRED ' Business Name(D/B/A) "I, the undersigned individually, or if a registered legal entity for itself, its officers and directors, hereby swear or affirm that I am duly authorized to make the above and foregoing application and, as such, I hereby swear j or affirm that the attached sketch is a true and correct representation of the extended licensed premises and agree that the place of business may be inspected and searched during business hours or at any time business is being conducted on the premises without a search warrant by officers of the Division of Alcoholic Beverages and Tobacco, the sheriff, his deputies, and police officers for the purposes of determining compliance with the beverage and cigarette laws." I swear under oath or affirmation under penalty of perjury as provided for in Sections 559.791, 562.45 and 837.06, Florida Statutes that the foregoing information is true and correct." If applying for a temporary extension,check the box to confirm the following statement: VI understand that the premises must be restored to its original form at the conclusion of the uth"orized temporary event." STATE OF �er(ua COUNTY OF tel I i APPLICANT SIGNATURE APPLICANT SIGNATURE The foregoing was ( ) Sworn to and Subscribed OR( )Acknowledged Before me this Day of , 20 , By who is ( ) personally (print name(s) of person(s) making statement) i known to me OR ( )who produced as identification. i Commission Expires: Notary Public I I Auth.61A-5.0017 3 I SECTION,6 DESCRIPTION OF PREMISES TO BE LICENSED �' Business Name (D/B/A) 1. Yes ❑ No ❑ Is the proposed premises movable or able to be moved? 2. Yes ❑ No ❑ Is there any access through the premises to any area over which you do not have dominion and control? 3. Yes ❑ No ❑ Are there..more than 3 separate rooms or enclosures with permanent bars or counters? 4. Yes ❑ No ❑ Is the business located within a Specialty Center? If yes, check the applicable statute: ❑ 561.20(2)(b)1, F.S. or El 561.20(2)(b)2, F.S. Neatly draw a floor plan of the premises in ink,including sidewalks and other outside areas which are contiguous to the premises,walls,doors,counters,sales areas,storage areas, restrooms, bar locations and any other specific areas which are part of the premises sought to be licensed. A multi-story building where the entire building is to be licensed must show the details of each floor. _ I i I I I I i I i i I Auth.61A-5.0017 4 Casa Amigos Mexican Restaurant 7950 US-1,Port St. Lucie, FL 34952 September 15th,2018—Mexican Independence Day-1 Day permit TQ RANKt t t t Grass t t Grass t------------------------------------- 0 o O O O t o z X Block Off t ULU S, 1 o Moving Rail t t I t m 0 010 t t t -- --_ t \ t Side Walk IT� \ t t t t CASA AMIGOS EXIT f I t i E - � t t