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PLANNING E dEVkL6PW&f
BOARD OF SERVICES D@P,AlaTMENT•
COUNTY
COMMISSIONERS Building and C6dak*g6tatl6n,
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Elevation Affidavit
Date a�0
Property Add ess /%
Pcmtit fi_ Flood Zone
The non-habiable/non-midential building (a=muiry shuetui e) cannot lie
converted to a habitable dwelling writ unless it is modified V ith a tnrildlng p"- cot
to comply with the relevant elevation requimment. i
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,Aid
i
t user's Name ,Sight of r
STATE OF FLORIDA
:OUNTYOF ti� LItGEF
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KELLYWILLIAMS `
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41 1�3;
mission 111103*