HomeMy WebLinkAboutGolden Ponds - 43557ST. LUCIE COUNTY PERMIT APPLICATIO �� 761
PERMIT NO./ ( CODE SEWAGE PERMIT NO. —
APPLICATION FOR PERMIT TO CONSTRUCT
JOB LOCATION/ADDRESS: 1r751 ks-pol� &Dd R 6-41 J
r, .. N --
LEGAL DESCRIPTION
ROAD IMPACT: DISTRICT —_ _ — ZONE -- FEE —
S/D pn5 8� _— MAP #---- FLOOD ZONE _ ELEV --
LOT D BLOCK — UNIT _ SEC 6) __ TWP 3S5--- RGE 3
TAX ID #—� 3 G3 --- c — OC�A,5 — 0001 rj —
ZONE
GMPP
LOT SIZE/DIMENSIONS '�s 0f — EST COST `►' as
SET BACKS: FRONT _ REAR —� — SIDE �. ,�}r�tc � SIDE I S' -s r ac . r ,ac ,
SQ FT BUILDING: LIVING AREA _— ACCESSORY
41
ARC MI TEI.I
l�
NAME �--3 1 Is PHONE
ADDRESS
ST ZIP
CONTRACTOR: STATE REEG/\C—ERT �$_� - I 5A g _ COUNTY CERT # 'S 4—N-
NAME 1�1`(1 ��Q �Y' `� ADDRESS —Aw o a q-vn Aoc,S-Lo,
CITY Vl2-!D;: ����. STATE PHONE_. Q
CITY
OWNER OF NAME —an\A�1 PG t) A S
PROPERTY:
ADDRESS �� �� PHONE
CITY =_\J�CL'L�i� 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 contain i e foregoing p i ati is true ct.
4
Applicant
SlAorn to and subscribed before me this
day of C�
Notary Pubfi— Sta
SCHOOL IMPACT FEES
Required []Yes ❑ No
Amt. Pd
My Commission expiresI__
Date Pd
Posted
50 i
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