HomeMy WebLinkAboutSigned Elevation AffidavitBOARD OF
COUNTY
COMMISSIONERS
Date
Property Address
Permit
i
PLANNIlivisloi
G &
DEVELOENT
SERVES
DEPARENT
Building a
Code
Regulatio
Elevation Affidavit
Flood Zone
The non -habitable / non-residential building (accessory structure) cannc be
converted to a habitable dwelling unit unless it is modified with a buildi, g permit
to comply with the relevant elevation requirement.
Print Owner's Name Signature of Owner
STATE OF FLORIDA
COUNTY OF n VUC&
The foregoing instrun nt was eknowledged before me this ✓ day of L_, 20g�
by U I'� personally known to me or who ha produced
as identification.
MYRANDAWHOU
Signa fNotaryPublic 4� = MY COMMISSION1{HH 1744
' I OU4''')' / n'+;pq EXPIRES: November 24, 4
Commission Number
i
Website: www.s"U co. ov
2306 Virgoi,,,Oa Avenue - Fort Pierco, Fl_. 349e2-5652
Phone (772) 462-1553 i•AX (772) 462-4578