HomeMy WebLinkAboutAffadavit (1)DocuSign Envelope ID: 044AA769-13BE-4250-8A85-AOFA2AE1EF53
GROZA BUILDERS, INC.
511 SW Port St. Lucie Blvd.
Port St. Lucie, FL 34953
(772) 336-7653
CGC1524734
Date:
To Whom It May Concern:
I (We) CI,�;��o c,,tcl FYI o� I o-v- V , hereby authorize Groza Builders,
Inc. to act as my (our) General Contractor/Agent for the Health, Utilities, Planning &
Zoning, Building and any other departments as required to obtain permits for the
construction of a new residential home located at:
Lot: Block:
Unit:
Address: 5-7 .A" ,-1- Qt tree (, . 3 Li q1 S I
Thank You,
rDocuSigned by:
G 11-6L h,
Signature
DocuSiggnned by:
89759EB775024D8_.
Signature
State of: 7— � a,,-; d, County of: � L�-Jc:t-e_
The foregoing instrument ws acknowledged before me this day of ao2i
20 by Lyyj , cl,,ic.. 4 ic, L1cric whom O is personally known to me, or ( )
has produced �,`,�� I ,yam as identification, and who did not take oath.
Notary Signature: (Notary Seal)
Kolly Finley
Notary Public
State of Florida
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Comm#HHOS2506
Explres 1/19/2025