HomeMy WebLinkAboutElevation AffidavitBOARD OF
COUNTY
COMMISSIONERS
Date \Z\\3�\A�
Property Address
Permit #
PLANNING & DEVELOPMENT
SERVICES DEPARTMENT
Building and Code Regulation
Division
Elevation Affidavit
Flood Zone
The non -habitable / non-residential building (accessory structure) cannot be
converted to a habitable dwelling unit unless it is modified with a building permit
to comply with the relevant elevation requirement.
b a �
Print Owner's Name
STATE OF FLORIDA
COUNTY OF ST wt-ci-6-
Signature f Ow er
The foregoing instrument was acknowledged before me this / 34" day of 1 20jq
by 0, n personally known to me or who has produced
n a . as identification.
Signature of Notary Public 01
GCS 00 9 3W le
Commission Number MYCAMMISSIGN#GG009206
�v�5 EXPIRES: Gctober4, 2020
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Website: www.sllucieco.00v
2300 Virginia Avenue - Fort Pierce, FL. 34982-5652
Phone (772) 462-1553 FAX (772) 462-1578