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HomeMy WebLinkAboutElevation AffidavitBOARD OF COUNTY COMMISSIONERS Date -Z / I q1 70?Z t 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. Print Owner's NarnV Signature of Owner STATE OF FLORIDA COUNTY OF_�A_.\A" 14, The foreZ�l instrument was ackn wledged before me this �6 day of Mc ,j-C,\\ , 20Qk by 0VY personally known to me or who has produced as identification. 4&1x� Signature of Notary Public Zp R Michael MWWWO Notary Public iri�©a a a —State of Florida Comm# HH025672 Commission Number Expires 7/30/2024 Website: www.stfucieco.gov 2300 Virginia Avenue - Fort Pierce, FL. 349825652 Phone (772) 462-1553 FAX (772) 462-1578