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PERMIT # ` I 1 ' RECEIPT #
Planning & Development Services Department
Building & Code Regulations
2300 Virginia Ave
Fort Pierce, Fl 34982
772-462-1553
APPLICATION FOR ZONING COMPLIANCE - HOME OCCUPA ION
Date: /91
Business Name:
Business Addres
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Description of Type of Business: r�
Property Tax ID #:
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Applicant's Name: ► .(j AQ Ph ne: �
Applicant's Address: 15,1eeri -1
City: _0� Lee State: / =L Zip:
I HEREBY ACKNOWLEDGE THAT THE ABOVE IS CORRECT AND AGREE TO CONFORM TO THE
ST. LUCIE COUNTY ZONING AND BUILDING CODE. ANY VIOLATION OF THE "HOME
OCCUPATION" WILL BE PURSUED THROUGH ST. LUCIE CODE ENFORCEMENT.
p cant's Signature
OFFICE USE ONLY
Date:
Subdivision:
Section: ITownship:
Zoning: Land Use:
Certificate of Competency Required: No Yes
Type of Certification:
SLCPDSD Revised 5/1/2014
Block:
Range:
Number
Initials:
Lot:
Map #: _