HomeMy WebLinkAboutZoning Compliance/Use Permit OFFICE USE ONLY: DATE FEM: i • PEf U#:
cost 900
PLANNING&DEVELOPMENT SERVICES .
BUILDING&CODE REGULATIONS DIVISION IVE
2300 Virginia Avenue RECElft
R.Pierce,Fl.34982-5652
772-462-1553 Fax 772462-1578 JAN 2 2 2019
APPLICATION FOR TEMPORARY USE P
St. .Lucie County, FL
BUSINESS NAME: `V �v
NAME OF EVEN' •
431PORY UBE
LOCA6► i��� FC1�� -)nye,EVENT: /
PROPERTY TAR IDENTIFICATION#:
DESCRIPTION OF TEMPORARY USE: ' J -,f r
A('DATES OF THE EVENT-
APPLICANT'S NAME:
APPLICANT'S STREETADDRESS: V)A\
CITY; /11,�� STATE L ZIP CODE:
WILL THE EVENT HAVE A TEMPORARY LIQUOR LICENSE:YES X NO
WILL THE EVENT HAVE A TENT(s):YES L NO (up to 900,square feet exempt from fire permit)
WILL THE HAVE BANNERS/PENNANTSM AGS?YES /NO,z,—(0*1 per 300 linear feet;32 sq ft ma:size)
I HEREBY ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT AND AGREE TO CONFORM TO
ST.LUCIE COUNTYLAND DEVELOPMENT CODE,SECTION 8.02.0 ,z1,4e,
PRINT APPLICANT'S NAME SIGNAT6RFtbF APPLICANT'
STATE OF FLORIDA,COUNTY OF �
ACKNO G BEF DAY OF C' W20BY (� p WHO IS PERSONALLY I W
OR WHO HAS PRODUCED A9IDENTIFICATION.
-0 ft,60- Ck
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
TITLE: NOTARY PUBLIC COMMISSION NUMBER:
SLCPDS 10/19)2015
o�"Rro��('••• CARLA NELSON
Notary Public-State of Florida
Commission#FF 965535
°•.;o���qP: My Comm.Expires Feb 28,2020
PERMISSION FROM OWNER OF PROPERTY
DATE: fla,4A
AS OWNER OF THE FOLLOWING DESCRIBED PROPERTY,I AUTHORIZES'C� 1�t \AC'1Q1.1
TO HOLD A TEMPORARY USE EVENT.
PROPERTY TAR IDENTIFICATION t. ) ��i OM M05b -
LEGAL DESCRIPTION OF PROPERTY.
PROPERTY ADDRESS:
OWNER INFORMATION:
PROPERTY OWNER'S NAME:
PROPERTY OWNER'S ADDRESS: -\ v� i-
CITY: � � 1�'(tee STATE: ZIP CODE:
9 1 &
OWNER'S NAME SIGNATURE O OWNER
STATE OF FLORIDA,COUNTY OF 15. Com_
ACKNOWLEDGED BEFORE ME THIS 5.�- DAY OF 20
By WHO IS PERSONAL KNOWN TO ME
OR WHO HAS PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINTNAME OF NOTARY
TITLE: NOTARY PUBLIC COMMISSION NUMBER:
C
OSP °a, CARLA NELSON
Notary Public
CAR:
State of Florida
' seal
cam= Commission#FF 965535
FF%o My Comm.Expires Feb 28 2020
., ���,
SLCPDS 10/19/2015
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FSECTION 6 DESCRIPTION OF PREMISE$TO BE LICENSED {
Business Name(D/B/A)
Spring Festival
.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❑ 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.
Te'M
Auth.61A-5.0017 4
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 0212013
If you have any questions or need assistance in completing this application,please contact the Division of
Alcoholic Beverages& Tobacco's(AB&7)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.myfloridalicense.com/dbpr/6bt/district offices/licensina.html
CHECKIRANSACTION—REQUESTED.,
Transaction Type:
Temporary Extension ❑ Amended Sketch
Permanent Extension
SECTt0K _LICENSE INFORMATION
Licensee(as listed on alcoholic beverage license)
Nettles Island Mens Club Inc
Business Name(D/B/A)
Nettels Island S-Priniz Festival
Location Address(Street)
9801 S.Ocean Dr.
City County State Zip Code
ensen Beach St.Lucie FL 134957
Alcoholic Beverage License Number Series Type/Class
BEV5302588 11C
Business Telephone Number Email Address(Optional)
772 208 7929 ext. Reinitahalladav@gmaff.com
FOR TEMPORARY EXTENSIONS ONLY.
Date(s)of Extension:
ABT District Office Received/Date Stamp
Auth.61A-5.0017 1
s
4 TI
: : SECON 3 ZONING APPROVAL
TO BE COMPLETED#BY THE ZONING AUTHORITY GO1/ERN(NG YOUR BUSINESS LOCATION
,?: This section onl a '�lies,to,a`�' e'inanent or tem ora, .extension of,licensed remises ,._�;, , „,
Location Street Address
9801 S.Ocean Dr.
City County J Zip Code
Jensen Beach St.Lucie FL 34957
Are there outside areas which are contiguous to the premises which are to be part of the premises sought
to be licensed?" ❑Yes ❑ 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.
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.
GU` r
Signed: (/tom Title: Date: /'
This approval is valid until 7—
H-'.-
SECTION 4 HEALTH s
TO BE COMPLETED BY'THE DIVISION OF HOTELS AND RESTAURANTS
.� '_ - `OR COUNTY HEALTH AUTHORITY
OR DEPARTMENT OF HEALTH t
OR DEPART,.MENT;OFAGRICU,LTURE`�;CONSUMERSER�ICES = _ `
The above establishment complies with the requirements of the Florida Sanitary Code.
Signed Date
Title
Agency
This approval is valid until
Auth.61A-6.0017 2
r SECTION5 :AFFIDAVIT OF APPLICANT r r
,NO�ARIZATLONREQUIRED
Business Name(D/B/A)
i
Nettels Island Sprina Festival
"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
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 n -
V,applying for a temporary extension,check the box to confirm the following statement:
"I understand that the premises must be restored to its original form at the conclusion of the
authorized temporary event."
STATE OF 6v
COUNTY OF S
WpWicAINT SIGNATURE
APPLICANT SIGNATURE
The.foregoing was(�4/swom to and Subscribed OR( )Acknowledged Before me this Day
of ���� , 20 l-! , By2a, Bl who is(✓personally
(print ame(s)of person(s) makings tement)
known to me OR( )who produced as identification.
Commission Expires: S
Notary Public
°a�Pii''• CARLA NELSON
Notary Pbbiis State Or
Commission#FF 965535
My Comm.Expires Feb 28,2020
Auth.61A-5.0017 3
SECTION 6 DESCRIPTION OF PREMISES TO BE LICENSED
x
Business Name(D/B/A)
Nettels Island S rinR Festival
1. Yes ❑' No❑ I 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❑ 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.
Auth.61A-5.0017 4