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FOUNDATION ONLY AFFIDAVIT
Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce Fl. 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 SCANNED BY St. Lucie County Foundation only affidavit for residential accessory structures Permit No. /©f7 I kfP:Rca c/ . JAVi ag� understand that I am proceeding with the foundation at my own risk. I understand that there is no assurance that my permit for the entire structure will be granted and that I accept full responsibility for any changes that are required in the design including but not limited to elevated 18 inches above the crown of the road or above flood elevation. The foundation must meet the requirements of the engineered drawing submitted at the time of permitting. Please be advised minimum required setbacks must be met for any future structure in accordance with the applicable zoning district. Contractor/Owner Bu STATE OF FLORt`ppX COUNTY OF The forgoing instru nt was acknowledged before me T tis day of � �� 20�by of person of FILE COY Personally Known OR Produced Identification ' Type of Identification Produced 7/, ANGELA M HUFF � Commission No. (Seal) o i � ;pY Uea.:'-: Notary Public -Slate of Florida % ;.. � , Commission N FF 234730 �ti' � My Comm. Expires May 27, 2019 i - .„i•hmnh Natinwi Nn;ary Ps�n , C 1 /