HomeMy WebLinkAboutRaymon E Sisco-4360607 ma 07 It 0Z
ST. LUCIE COUNTY PERMIT APPLICATION
PERMIT NO. ( CODE # ) SEWAGE PERMIT NO
APPLICATION FOR PERMIT TO CONSTRUCT
JOB LOCATION/ADDRESS:
/ DRIVEWAY PERMIT
LEGAL DESCRIPTION Xd;s
Yes
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ROAD IMPACT: DISTRICT ZONE FE
S/D MAP FLOOD ZONE ELEV
LOT BLOCK __ _UNIT SEC TWP RGE
PROPERTY TAX ID$_
l l ZONE GMPP.
LOT SIZE/DIMENSIONS f �- :) �2 EST COST mil%
SET BACKS: FRONT 7 / REAR /c� i SIDE _ r/' "`!`> SIDE v
SQ FT BUILDING: LIVING AREA ACCESSORY
ARCHITECT: NAME PHONE —
ADDRESS — CITY ST ZIP
CONTRACTOR- STATE REG/CERT # — COUNTY CERT #
NAME �7Czio�. / i ADDRESS
CITY STATE ZIP PHONE
OWNER OF NAME ���/1��� -'' ��'✓�
PROPERTY:
ADDRESS 5 9 % % �J '~'Cr/.---4'Zf ° PHONE
CITY /�.�1.STATE ZIP
STATE OF FLORIDA, COUNTY OF ST. LUCIE
Before me, the undersigned authority, personally appeared _, who upon
being duly sworn, deposes and says that the information contained in th orego' application is true and correct.
Applicant
`.vorn to and subscribed before me this day of Zc' 19i
SCHOOL IMPACT FEES
Required ❑ Yes ❑ No
Notary Public, State of Florida at Large
Amt. Pd
My Commission expires: Date Pd
Posted —
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WEALBANENE q) 10 5455 ARCHITECTS' STANDARD FORM
DATE
APPROVED By
NG NUMBER