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Home My WebLink AboutZoning Compliance/Use Permit QFFICE USE ONLY: DATE FILED: 4j �' PERAIIT Cost; $55A PLANNING&DEVELOPMENT SERVI BUILDING&CODE REGULATIONS DIMSRr', " ;2300 Virginia Avenue Ir n Er�°� � , a. PQ asp r COUNTY Ft.Pierce,FL 34982-5652 772-462-1553, Fax 772-462-1578 FEB 212020 APPLICATION FOR TEMPORARY U EkiAWrmit.ting L)e pe rt e ht St, Lucie County, FL BUSINESS NAME: NAME OF EVENT: a!w as e LOCATION AND ADDRESS OF TEMPORY USE EVEV. PROPERTY TAX IDENTIFICATION#: r� — 0, � .; DESCRIPTION OF TEMPORARY USE: 'One- �a�1�"L, L ei I Pte.,j /D X ) V � DATES OF THE EVENT: .Z " APPLICANT'S NAME: P ry Ste. M5 APPLICANT'S STREET ADDRESS: -;(o-7L,, rnGK�stY>r j 9d CITY: �{"• �.,-c P_ STATE: 'r' L— ZIP CODE: Aq WILL THE EVENT HAVE A TEMPORARY LIQUOR LICENSE:YES " NO WILL THE EVENT HAVE A TENT(s):YES V""'NO (up to 900 square feet exempt from fire permit) WILL THE HAVE BANNERS/PENNANTS/FLAGS?YES /NO L! (Only 1 pet 300 linear feet;32 sq ft max size) I HEREBY ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT AND AGREE TO CONFORM TO ST.LUCIE COUNTY LAND DEVELOPMENT CODE7NAT 8.02.02J.fVSe �mPRINT APPLICANT'S NAME URE OF APPLIC STATE OF FLORIDA,COUNTY OF L--kA C-9'&- ACKNOWLEDGED SL' -_ ACKNOWLEDGED BEFORE THIS I!a_ DAY OF t��O\A A �20� BY_ � P_Nn�r,�,e F>\� V—,c WHO IS PERSONALLY KN TOME OR WH ' HAS PRODUC AS IDENTIFICA�. SI A F NOTARY TYPE OR PRINT NAME OF NOTARY N ARY PUBLIC COMMISSION NUMBER: SLCPDS 10119401S di LWlA WALKER =P: ..'__Coaarlission#GG 365562 Expires December 5,2021 6w"7huTmyFainki=r-Ce800.365.7019 , PERNIISSION FROM OWNER OF PROPERTY DATE: ig AS OWNER OF THE FOLLOWING DESCRIBED PROPERTY,I AUTHORIZE h&ot se— - _—___ `�? iaTO HOLD A TEMPORARY USE EVENT. PROPERTY TAX IDENTIFICATION#: LEGAL DESCRIPTION OF PROPERTY: ` PROPERTY ADDRESS: �1. 4?�.3 002c ,Q_ �-e ISL s OWNER INFORMATION: PROPERTY OWNER'S NAME: t, 55 olr-ol �Qe✓ti5 i �Lrr,Ql PROPERTY OWNER'S ADDRESS: { CITY: Pi rc.P_.- STATEN ZIP CODE: _ PRINT OWNER'S NAME SIGNATURE OF OWNER STATE OF FLORIDA,COUNTY OF ACKNOWLEDGED BEFORE ME THIS DAY OF 20.� BY -. WHO IS PERSONALLY KNOWN TO ME,),< OR O HAS PRODUCED AS IDENTIFICATION, GNA OF NOTARY TYPE OR PRINT NAME OF NOTARY E: OTARY PUBLIC COMMISSION NUMBER: JULiANAWALKER Conurassion#GG 165562 Expires December 5,2021 � seal FSR'•` 8a+aea7l.uTr�yFan5,2021saa3s5tats SLCPDS 10119t2015 DBPR ABT-6003—Division of Alcoholic Beverages and Tobacco Application for One/Two/Three 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&T) 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 insure the permit is issued by the event date. This application may be submitted by mail, or it can be dropped off. A District Office Address and Contact Information Sheet can be found on AB&T's page of the DBPR web site at the link provided,below. hfp://www.myfloridalicense.com/dbpr/abt/district offices/licensingc�html CT SAION'RE' - D ,a Transaction Type: ® One/Two/Three Day Permit- ❑ Special Sales License SECn Z� PERMIT ;.� ...,,� ., . .�,<�� 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) 57-0564993 772 4751158 btbeaty68l@gmaii.com Full Name of Applicant(s): (This is the namethe permit or license will be issued in) Department of State Document# National Wild Turkey Federation, Inc. F0300000_3.125 Business Name (D/B/A) or Name of Event Palmetto Coastal Sportsmen Chapter Spring Banquet Location of Event(Street and Number) 26003 Orange Avenue City County State Zip Code Fort Pierce St. Licie FL 34945 Mailing Address (Street or P.O. Box) 3676 South Brocksmith Road City State Zip Code Fort Pierce IFL 34945 Contact Person -This section is optional,see application instructions for details Contact Person Telephone Number Bryan Beaty 772 201 5371 ext. Email Address (Optional) btbeat 681 mail.com Mailing Address (Street or P.O. Box) 1493 South Brocksmith Road City State Zip Code Fort Pierce FL 34945 Date(s) Permit Desired 3/7/2020 ABT District Office Received Date Stamp Auth: 61A-5.0013,FAC 1 aSEC `tON�32SALES .r„trb '�2 t' r`�.°i`C-i t�"L •1�''2,�„tom x4' x.'�y_. u a..:'P+,-�i's.,,9�.�x ...;,s t -.-..F.n "F ,.��,E xcr,-i; ��.�..'a'�'_;'+,.. '"v'1L a'� ''t ?' Xr v�..,r`�.. 9 Full Name of Applicant Organization National Wild Turkey Federation, 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: ° ti � TO B�COMPLETEDMB„Y,;�?HE ZONING;AUTHQRI'1�Y�G�YEf�HINGTHE�E�1lENT°�LOCATION;r��"a�.w,�x,,�:, Location of Event(Street and Number) 26003 Orange Avenue City County Fort Pierce St. Wile The location complies with zoning requirements for the temporary sale of alcoholic beverages pursuant to this application for a One/Tw /Three Day Permit. Signed It Date Moq lgoao Title Y1. ” r Note: College fraternities and sororities must meet certain additional conditions which can be found in the application instructions and requirements. Auth: 61A-6.0013,FAC 2 -�� SECTION 5 DESC13.IPTION�OF�PREMISES,�'OrBE LICENSED ��x „� , �` 13Y` ��' '� Business Name (D/B/A) or Name of Event Palmetto Coastal Sportsmen Chapter Spring Banquet 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. Tom. Auth: 61A-5.0013,FAC 3 4 Y � � AOR NON`fiROFI'TCIVIC�ORGANIZAT�O�`hALC01iOL'IC�BEUE�GE PERMI'i�4��'�� '��_ ------------ Full Name of Applicant Organization National Wild Turkey Federation, 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 agree 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 and is 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 _ 0(LIc�0. COUNTY OF' ,%. Luc,�P_ Lon APPLItANT/AUTHC5RIZED REPRESENTATIVE NAME E APPTCANT/AUTHORP-ED REPRESENTATIVE SIGNATURE The foregoing was ( ) Sworn to and Subscribed before methisDay of'Feb . 20 2.t7 By who is personally known to me (print a e(s) of person making st ment) OR ( )who produced as identification. Commission Expires: Nota P blit AXLWWAMR f. Commission#GG 165562 Rzz Exores December 5,2021 ;°!' Boded ihw 7nmy Fein Yuurmce 6009857019 Auth: 61A-5.0013,FAC 4