HomeMy WebLinkAboutApplication for Zoning Compliance - Use Permit PLANNING AND DEVELOPMENT SERVICES FDEC
ECEIVED
2300 Virginia Ave
• Fort Pierce,FL 34982 2 3 2019
Phone: 772-462-2822-Fax: 772-462-1581
e County, Permitting
APPLICATION
FORA BUS/NESS NAME OR OWNERSHIP CHANGE Oft Y
(Not Home Office Use)
Permit Number: (�d1 d�� Date of A lication: ) Z3 1
BUSINESS INFORMATION_
Name of Business: A- Es'A G-FNew Business Business Name(if changing):
Name of Current Business Owner:
Name of New Business Owner -s-uN Y4 N YE-
Address of Business: `00/ (7 6(s 64-jy ( pS'C- State: L Zip:
Name.of Shopping Center, if applicable: FvuN-m-%t' P )4-z-A
Property Tax ID #for Business Location: 3`1 \y - So 1 - 3—I 15 - d So-
Description of Business: (include a detailed description)
Name &Type of Previous Business at this Location:
Attach a copy of the current,active copy of the Business Tax Receipt for the business/property.
APPLICANT MAILING ADDRESS=
Name of Applicant:
Address: State: Zip:
Phone Number: Email Address:
This application is only to update an owner name or business name. To qualify for this application,there must be an active
business tax receipt for the business/property;no change of use(change or modification of the character,type or intensity of an
existing use or the inclusion of additional uses) may be proposed; and no erection, alteration, construction, reconstruction or
any type of development involving a building, structure, paved parking area, driveway connection, or impact upon a protected
natural habitat. I further understand that a site inspection may be required to ensure compliance with applicable land
development,building safety,and property maintenance regulations.
Applicant's Signature: ` (, Date: t>-
:OFFICE USF:ONLY .
Required Yes No Comments
POD Initials Business Tax Receipt
Revised:March 2019