HomeMy WebLinkAboutRichard & Jeanene Kohler- 43638ST. LUCIE COUNTY PERMIT APPLIC
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PERMIT NO. q3 43�r ( CODE $k ) SEWAGE PERMIT NO.
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APPLICATION FOR PERMIT TO/CONSTRUCT
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LEGAL DESCRIPTION _
ROAD IMPACT: DISTRICT
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PROPERTY TAX ID # 32i- 64 7 G*2y?
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ARCHITECT:
CONTRACTOR:
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NAME
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STATE REG/CERT #
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CITY
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ST ZIP
STATE ZIP PHONE
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PROPERTY: ADDRESS 4- PHONE PHONE 1166 —� 7GG
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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 contai� i the rego' g appl' tin is true and correct.
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Applicant
Sworn to and subscribed before me this day of
SCHOOL IMPA T FEES
Required ❑ Yes ❑ No
Notary Public, State of Florida at Large Amt. Pd
My Commission expires: Date Pd Posted
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