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HomeMy WebLinkAboutZoning Compliance/Use Permit OFFICE USE ONLY: DATE FILED: A.1 Z X01 ` PERMIT#: Cost: $55.00 _ PLANNING&DEVELOPMENT SERVICES - 5 •--- - 'J"Y ' ' '` �_ F� BUILDING&CODE REGULATIONS DIVISION • 2300 Virginia Avenue RECEIVE® o . — Ft.Pierce,FL 34982-5652 — 772-462-1553 Fax 772-462-1578 S E P 2 6 2019 ST. Lucie County, Permitting APPLICATION FOR TEMPORARY USE PERMIT -BUSINESS NAME: 5+ LUe-r 2 Qun (ZcLjI Pn�S ASS x- :T7^e- NAME OF EVENT: Car-Ae rS C-6 4n#'Ale Qrti1 V �T�/ LOCATION AND ADDRESS OF TEMPORY USE EVENT: 15go1 o rr,._o•e-.. venin r+ :2 yqyi�— PROPERTY TAX IDENTIFICATION DESCRIPTION-OF TEMPORARY USE: qD DATES OF THE'EVENT: APPLICANT'S NAME:s61. L-tcr,t_ CpvA �J��e,�',; A-5suc!"O n APPLICANT'S-STREET-ADDRESS: L5 k6lV-wr A P- - CITY: -• t L r c.2— STATE: Fl_ ZIP CODE: 3y q�l 5 WILL THE EVENT HAVE A TEMPORARY LIQUOR LICENSE:YES; WILL THE EVENTHAVE A TENT(s):.YES. . . .'_NO:- (up to 900 square,feet exempt from fire permit) WILL THE HAVE BANNERS/PENNANTS/FLAGS?YES /NO (Only 1 per 300 linear feet;32 sq ft max size) I HEREBY ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT AlvD AG E TO CONFO'> M TO ST.LUCIE COUNTY LAND DEVELOPMENT CODE,SECTION 8.02.02J. PRINT APPLICANT'S RAME 'ATkRE OF APPLI ANT STATE OF FLORIDA,COUNTY OF LVL CJ(e. ACKNOWLEDGED BEFORE ME THIS -C_�,U DAY OF__!!E beN,20 [ �, BY CL�y�t�y CJS WHO IS PEI SOkV I-ILY t .TO ME U, gDtfc" irrvr, OR O HA �; „� r,. .;� ' �C'�tt s,t ,' c�r��AS.IDEN. ICATION. w i t'"{ 'Y.:i� `. C:.u�:,t'.1:::fi1':i:i3tEuJSl:i�} 'nt.�i•.`t ifif) 1 t. .;,i:�_ .r ,i ;•a;..Ha.; t 'r' __i ;i`3 ;t:rrr,7 ic�lCse eqf:f�•<:;a NAT E OF NOTARY TYPE OR-PRINT NAME OF NOTARY TI OTARY PUBLIC COMMISSION NUMBER: SLCPDS 10/19/2015 � �65582 -` e`°Expires December 5,2021 s' ••~:+ooa;°;�'• Baled'IMiTrgFainfnsuranca800.3dSdOt9 PERMISSION FROM OWNER OF.PROPERTY DATE: Lzsj- AS I 1 OWNER OF THE FOLLOWING DESCRIBED PROPERTY,'I•AUTHORIZE CJu.,A4 C t-- d e M Pry, fa ASSN I"O,IN TO HOLD A TEMPORARY USE EVENT. PROPERTY TAX IDENTIFICATION#: 305SOS O Of 1 — 00o- LEGAL DESCRIPTION OF PROPERTY: LOun'tM Liv.,,p FS- S& L 14 .4.L D-r t� oP, 33(0'---79q -13)b- CL 3)b9 PROPERTY ADDRESS: I s go l ©ren(�2, �C 2_ �—r- t eI�P eeL �1(g� 1go� OWNER INFORMATION: PROPERTY OWNER'S,NAME: Z CA-K- 1, PROPERTY OWNER'S ADDRESS: ,0 nn CITY: -`— 1✓,e t� STATE: EL ZIP CODE: 3' r PRINT NER'S NAME - GNAT O OWNER STATE OF FLORIDA,COUNTY OF ACKNOWLEDGED BEFORE ME THIS QtO DAY OF` BY �( � Cs.�'-t�Y WHO IS PERSONALLY KNOWN TO ME OR O HAS PRODUCED AS IDENTIFICATION. SIGNA URE OF NOTARY 'TYPE OR PRINT NAME OF NOTARY TITLE: NOTARY PUBLIC COMMISSION•NUMBER: �p!vii9i •. &gMWAMR �, ,.a FVires December 5,2021 $ COOS GG 165562 ° t:N°•`' BoodedTltnrTroyFatn{asutan -^ ;►, ^':E*_m December 5,2021 , . :, �°«...,••' Bcnd�d]M1TtgFsin680�3Q57019 SLCPDS 10/19!2015 SUi� ;iF r%tl:}ik:4:;:�c[wF:J;1 ?,.• !F-, .!r (iTJ:ki()i':i1Y�;Y.')�=i;s.'r":,�. •is l:iT.:.���!hvC-b'v i'sflf Gf:y�l:1�UYit�'fr"`_' j : C'• DBPR ABT-6003—Division of Alcoholic Beverages and Tobacco Application for One/Two/rhree Day Permit or Special Sales License STATE OF FLORIDA DBPR Form DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ABT-6003 Revised 08/2013 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 to your local district,office at least(7) days prior to the first date of the event to i ermit is issued by the event date. This application may be submitted by mail,or it can be dropp d off. Rees e Address and Contact Information Sheet can be found on AB&T's page of th DBPR web site at the link provided below. SEP 2 6 2019 Local ABT Licensing Offices ` ST. Lucie county, Permitting' + �%L. :My�n1$11 a� � -���fi�����2���..n � �n��; -Y�7 �'•L����"�'��^_'��^ r`.Yi�'S �` .�d' $' '�-+,. huS.�" . "'�7�5�i�'. Transaction Type: ❑■ One/Two/Three Day Permit ❑ Special Sales License If the applicant is a corporation or other legal entity,enter the name and the document number as registered with the Florida Department of State Division of Corporations on the line below. FEIN Number Business Telephone Number E-Mail Address (Optional) 27-4441504 1772-201-5371 btbeaty681 @gmail.com Full Name of Applicant(s): (This is the name the permit or license will be issued in) Department of State Document# St. Lucie County Cattlemen's Association, Inc. N11000000106 Business Name(D/B/A)or Name of Event Carter's Grocery 40th Anniversary Location of Event(Street and Number) 15901 Orange Avenue City County State I Zip Code Fort Pierce I St. Lucie I FL 134945 Mailing Address(Street or P.O. Box) 1493 S. Brocksmith Road City State I Zip Code Fort Pierce IFL 134945 Contact Person -This section is optional, see application instructions for details Contact Person Telephone Number Bryan Beaty 1772-201-5371 ext. Email Address(Optional) btbeaty681 @gmail.com Mailing Address(Street or P.O. Box) 1493 S. Brocksmith Road City State Zip Code Fort Pierce IFL 134945 ftib'872019 10/05/2019 10/05/2019 ABT District Office Received Date Stamp Auth: 61A-5.0013,FAC 1 xt �rh -�� ON r'. -NO Full Name of Applicant'Organization Errorl Reference source not found. St. Lucie County Cattlemen's Association, Inc. The named applicant for a license/permit has complied with the Florida Statutes concerning registration for sales and Use Tax and has agreed to pay any applicable taxes due. Signed Date Title Department of Revenue Stamp: d- �,���. Location of Event(Street and Number) 15901 Orange Avenue . City County - Fort PierceSt/L St. Lucie The location co4�j with zoning requirements for the temporary sale of alcoholic beverages pursuant to this application for /Three Day Permit. Signed I Date !E Title Note: College fraternities and sororities must meet certain additional conditions which can be found in the application instructions and requirements. Auth: 61 A 5.0013,FAC 2 � om ° } QNY5 _SDS. !fi .1bbt" - SSS XisfCND ��'�r.Y Business Name(D/B/A)or Name of Event St. Lucie County Cattlemen's Association, Inc.-Carter's Grocery 40th Anniversary 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 where the event will be held. A multi-story building where the entire building is to be licensed must show the details of each floor. li Auth: 61A-5.0013,FAC 3 r �"� '' lt�� � �s , � � � a`-e� .4 ''4���-e-. +.rF�O6't`,�`•,< s�, L.-« t -=��_�.� ���f ;i-Ea r^'.'-� "�c'}.�a''�&t� �,�,�• Full Name of Applicant Organization St. Lucie County Cattlemen's Associaiton, Inc. "This is to certify that the applicant requesting the permit in the above and foregoing application is a non-profit civic organization and that the permit, if used, will be used only by the organization making application, on the date(s) requested and at the location stated. By acceptance of this permit,we agree that the applicant organization, as the permit holder, is the ONLY entity that will receive any of the profits from the sale of alcoholic beverages on this permit. This is to further certify that the applicant organization has not received more than three(3) permits within the calendar year, unless otherwise authorized by law, and acknowledge that the location may be inspected and searched during the time that the permit is issued and business is being conducted without a search warrant by authorized agents or employees of the Division of Alcoholic Beverages and Tobacco, the Sheriff, his Deputies, and Police Officers for purposes of determining compliance with the alcoholic beverage laws. I,the undersigned individual, hereby swear or affirm that I am an officer or authorized representative and am duly authorized to make the above and foregoing statements on behalf of the applicant organization. Furthermore, 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 to the best of my knowledge." STATE OF tNk COUNTY OF P (CANT/AUTHOR ZED REPRESENTATIVE NAME -A/PLIcAiqT7WuTHOVZED REPRESENTATIVE SIGNATURE The foregoing was( )Sworn to and Subscribed before me this Day of 20 _, By who is( ersonally known to me (print e(s)of person making st ent) OR( )who produced as i ��� J^U_Ew.IA�NAW^AaLK^E^R Commission Expires: x Exom DemnW 5,2021 N614y Public �► 80o3E�7At9 Auth: 61A-5.0013,FAC 4 t S ATTESTATION This form is to be completed by the alcoholic beverage license holder ONLY when the event of the non profit organization is being held at a location that is licensed by the Division of Alcoholic Beverages&Tobacco for the sale of alcoholic beverages. Note:This attestation must have the original signature of the alcoholic beverage license holder(only persons on file with the division may sign)and must be submitted by the non-profit group along with the application for the One/Two/Three Day Permit. Licensee: Carter's Grocery Business Name(DBA): License#: - Series of Permanent License: BEV6600099 Type: Q Cop Contact Person Telephone Number Tobi Muller ext. E-Mail Address(Optional) tobi@cartersgrocery.com Name of Non-Profit Group: St. Lucie County Cattlemen's Association, Inc. Date(s)of Event 110/5/2019 IMPORTANT A One/Two/Three Day permit is being requested for an event to be held on your licensed premises. During the event, no sales or service of alcoholic beverages may be made under your alcoholic beverage license in the area identified for use by the non-profit organization.Failure to comply will result in administrative charges being filed against your,license. Signature of Licensee: Date: 00 1 Auth: 61A-5.0013,FAC 6 ZONING COMPLIANCE CERTIFICATE Planning&Development Services Building&Code Regulation Division 2300 Virginia Avenue Permit#: 1909-0544 Fort Pierce,FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Issue Date: 9/26/2019 This is to certify that the following discribed property is properly zoned for: TEMPORARY USE PERMIT FOR 1 DAY EVENT ON OCTOBER 5, 2019 WITH LIQUOR LICENSE. NO TENTS AND NO BANNERS. Type of Business: TEMPORARY USE PERMIT FOR 1 DAY EVENT ON OCTOBER-5, 2019 WITH LIQUOR LICENSE. NO TENTS AND NO BANNERS. Business Name and Address: ST LUCIE COUNTY CATTLEMEN'S ASSOCIATION INC 15901 ORANGE AVE, FORT PIERCE, FL 34945 Parcel ID No: 2212-421-0022-000/0 SIC Code: COC Required? . NO Signature Date