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Elevation Affidavit
Datq,
Property Address
Permit # 0-3 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 Name
STATE OF FLORIDA
COUNTY OF 5 4- LU" -C
Signature of Owner
The foregoing instrument was acknowledged before me this day of 20
by personally known tome or who has produced
1p Li as identification.
Signature of Notary PublicV
Commission Number l/
LEI',
ATHER BURF IRD
HEATHER
of Florida -Notary Public
mission # GG 183217 Commission ExpiresFebruary 06, 2022
Website: www.stlucieco.gov
2300'V,irginia Avenue - Fort Pierce, FL. 34982-5652
Phone (772) 462-1553 FAX (772) 462-1578