HomeMy WebLinkAboutLINDA FUSICK PERMIT 1UPFLEMENTiAL CONSTRUCTION UEN LAW IWORMATION:
OESiGNER/E N GINEER: _ Not Appiicabfe
Na me:
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City: — __-- State:
Zip: Rhone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
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City.,
Zip; Phone -
MORTGAGE COMPANY: Not Appii able
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city_ State;
Zip= _ _ _ Phone;
BONDING COMPANY: _Ncrt ,+gyp Ilea bie
Name:
Address. _ _ chy-
Zip:= _ Phone;
OWNERf CONF RACTORAFFIDVIT= AppJirahian k hereby made to otatai : a permit to dathe wars{ and jnstalLathon sec indimkcd.
I certify that: no work or in-#xlEati3n has commenced prior to the issuance of a permit
5R, LudeCcrunty makes no repre-' #�tion that is granting a permit will' authori?e. the rwrm it holder to build thu suhject structufe
which is in conflict with anopplicaMe Home Owners Assotiafian rulp5, 41avvs or and cow%enants du t may restriCt Or prohibit suds
stnu2ure. Faso consu tt wrth your Horse Ownt-c a Ayodittion and Tftiew your deed fair any which may apply.
in can5Werakion ofthe granting afthk reguc-sted perms I do hereby agfee that I wiN, in al'] respects, perfarmthe wpfk
in aomrdance with the appffplans, the F1'orida Building i 6-d end St. Lade County Arnendmenrs,
The €odlowing building p�rmjt-upplications are exempt from undergaing a full'concurrency rewicrr, room additions,
aoeesswy MracLures, swimming pools, krrms, walls, signs, screen raom!� and acrossory uses W another ruin-teziiiderhtial use
"VrARNNG T�O OWNEW YOUR FAA IRE TO RECORD A XIOTICE OF OOMMeNCMEJMfr MAY R€SULT IN ToUI. PAYING
T"JICE FOR IMPROVEMENTS TO YOUR PRROPJEJR'iY- A NOTICE OF MMMH EENEW MU5T BE RECORDM AND
POSTED ON THE JOB SITE BEFORE THE Fib MYSPEiv'FM. IF YINJ IJIITEND TO OBTAIN FIIt ANCINC, CONSULT
"11 TO1JR LEWER ORAN AITOi;EY BEFOIZE RECO2DINE; FOUR IMIOTICE OF COMM ENGEM"T."
Zkkure erf LemeejCo r itractn; u* {tu nt for Owner SignaEure rf L iC I JoIder
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C47I: OF FLFi CNT'i'F STATE OF OR'x, .
COUNTY OF � tiL; i �
The forWi:rg inorurnentwas a pwledged befom Tne
this3j O.uv ol'— 21r by
Name of person making slat�m,cri t.
Personalty Known Q R Pr-�)dvoed IdenLificat9Dn
Type -of 102ri l.i limW.n
Pradu,cedr.
F r%�r orate Soho
JS�gnadire of Notary- Pu' i uP,7.IC
sl-:57ATE CF FIC)RIGA
17Q=-scion No-
3fZ573
FR NT ZOMlNG
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
The forgoing - !Mm t was acHnowlmhWif be&re me
this . day of r 2Lk'-4 tyy
Name of person making simLernent
Personaily Known OP, Produced idenffiradan
Tyrp� of Iden#if i thm
Produced OLD` �01O O A
' FM.om
(Sknmre of Notary Puhbo- SATE OF i=L2RIDA
Como C43315=
REVIEW I
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