HomeMy WebLinkAboutELEVATION AFFIDAVITBOARD OF
COUNTY
COMMISSIONERS
Elevation Affidavit
Date
Property Address
Permit #216 �(- 67 �L/
PLANNING & DEVELOPMENT
SERVICES DEPARTMENT
Building and Code Regulation
Division
Flood Zone
RECEIVED
OCT 2 7 2021
Poemittingnty
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.
Qe)L_t_f'
Print Owner's Name
STATE OF FLORIDA
COUNTY OF
i'tr'j0_"_W 2�_(
Signature of wner
The foregoing instrument was acknowledged before me this Z day of �G%:�, 20_
by 1=1Npersonally known to me or who has produced
4 as identification.
HEATHER BURFORD
4,'p-sstate of Florida -Notary Public
Commission # GG 183217
Signature of Notary Pu lic ' 9My Commission Expires
��'0;;�°�` February 06, 2022
Commission Number
Website: www.stlucieco.gov
2300 Virginia Avenue - Fort Pierce, FL. 34982-5652
Phone (772) 462-1553 FAX (772) 462-1578