HomeMy WebLinkAboutPERMIT APPLICATION,� I.S AND PROPARTY
of our submitt i ST. LUCIE COUNTY PERMIT APPLI
r..w CATION 3
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1 7,e made yfor complia e 5 CANNED � (�
tlth ST. LUCIE COUN SEWAGE PERMIT NO.
yyo. EC 87 0 (CODE #-----
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i —112
E tiC s�
PLICA710N FOR P MIT TO CONSTRUCT
ZB LOCATION/ADD ESS:
t
GAL DESCRIPTION
�/l L;�4�c �V ONE FEE i )
OAD IMPACT: I)ITRICT CC% LEV
MAP
O ZONE�E
P � E
T— BLOCK — UNIT S —
�3 o - 000 — 000
OP RTY TAX ID I��i5
ONE t 3P
3 5� / �o T COST 7�� BOO.
_ � S
�C O E
x 7S�
7 "i
T SIZE/DIMENSIONSC �
E
T BACKS:
✓37 S� � ACCESSORY
/ IVINGAREA FT '�BUILDING:
i E�PHONE
ARCHITECT: AME �C�C Zu�� S7
!� ZIP ----
DDRESS 3`�3� �9/CARS FyC �OCITY L— ST
CONTACTOR:
OWNER OF
P'OPERTY:
dl1
�
PSTATE
�JOF FLORI
Before m
bein duly swor
Sworn to
I'
#" ATE REG/CERT
�� C & UNTY CERT # D
1ME v� �(f7Aj c)/-7 ADDRESS
TY r- �' STATE /C --ZIP PHONE,'
��
NAME ON C"g d
PHONE
ADDRESS _
j CITY i� �� STATE - t— ZIP
_
A, COUNTY OF ST. LUCIE
the undersigned authority, personally appe ed who upon
deposes and says that the information c tained i f r application is true and correct.
Applicant l
and subscribed before me this — day of
Notar blic, State"of Florida at Large
SCHOOL IMPACT FEE d 1—
Required ❑ Yes No PL- AN--s'--'s'W
Amt. Pd
Date Pd Posted