HomeMy WebLinkAboutPERMIT APPLICATIONnui>✓n1n�UIV' I�U11VU NffUNtltlY
Alr&evv IQf your submittal ST. Li CC' �tlI q OUNTY PERMIT- A�'i LICATION
be m d� for compliance
with ST! LUCIE COUNTY`,��1�a��
I�' '1�►(' EC 87(13. ---- -- --._ (CODESEWAGE2 1 LF
�+•___) PERMIT NO.
AP LIC TION FOR PERMIT TO CONSTRUCT
CONSTRUCT —f5 _
JOB LO- i ATION/ADDRESS: f G2 t� r L fi y CA C C _ `,a
L - AL DESCRIPTION
SITE Iif�, F11Z�
L. C
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ROAD IMPACT: i DIST ICT _ ZONE — FEE
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S/D _ __ MAP FLOOD ZONE ELEV
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LOI 9 BLOCK _ UNIT — SEC � TWP S RGE
PROPER Y TAX ID ;Y 5 o
ZONE l�fga
J�COST
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I /LOT SIZEI/DIMENSIONS �_�' 0 r x 3�0 E►'► 3S v-Dt
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SET BA l S: FRONT 0��REAI t SIDE Z�- �LQSIDE "'�-3 r � "
Su FT B '�`�
ILDING: LIVING 13 f Z G AREA ACCESSORY Radon:
ARCHIT II : NAME _ DRIVEWAY PER-IW9T-
- PHON%Ef • -
9 MUO
ADDRESS
CITY r ST ZIP _
CONTR CTOR: STATE REG/CERT �+•_ _ _ C�dWNT # NO
NAME ADDRESS
i
CITY STATE ZIP PHONE
OWNERIF AME _C g i2 �� / �r r� /z �= U— S
PROP RTY:
ADDRESS 4 F5 0 3 r4 sr PHONE -7�6 Z Z
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CITY _L= S 9 /�/-t r,, (3 l' /1 c / E STATE FL ZIP _ 2? 4/ b 7
STATE OI FLORIDA, COUNTY OF S7. LUC1E _ /,
B' fore me, the undersigned authority, personally appeared C 4 L f N ht D a r- w ,who upon
being d ly sworn, deposes and says that the information contained in the foregoing application is true and correct./
Applicant
S II orn to and subscribed before me this day of �e d aj;,r_
pry Public, State of Florida at Large
Commission expires: Z- / ' %"
SCHOOL IMPACT FEES
RequirIP4�-
d Yes ❑ No
Amt. 6D
Date Pd
Posted