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SAINT LUCIE COUNTY PROPERTY APPRAISER ST.
REQUEST FOR REAL PROPERTY SPLIT/COMBINATIOP
Notice: While the Saint Lucie County Property Appraiser's office makes every ettort to maintain the most current and accurate information
possible, there are no warranties expressed or implied for our data, its use, or its interpretation. The data maintained by this office is
developed and collected for the purpose of producing a property lax roll and as such should not be relied upon as legal determination of title
and/or boundaries.
BEFORE AN APPLICATION FOR A PARCEL SPLIT / COMBINATION CAN BE ACCEPTED
ALL PREVIOUS / CURRENT TAXES MUST BE PAID IN FULL SCANN
(Attach a copy of receipt / bill indicating paid in full)
ACTION REQUESTED: COMBINEro-17-p-ov
LIT❑ THE FOLLOWING PARCEL(S): St. LUCI2 Countyf3ol- bpk�01�D�OD(Y4YI-aDd:3
Special Comments or Instructions: /�/c/?r �_s'/niC 4,QI&TL/ C!, JTCl7E!_ V A6✓0/"7
Is parcel vacant? or improved? Fv_1, If improved, indicate location of building(s)
(Identify by parcel & address) ; yCIC//J SDI ayo )/
Title must be the same for all parcels being combined.
IN MAKING THIS REQUEST, I RECOGNIZE AND AGREE TO THE FOLLOWING:
1. This action does not nullify or alleviate any existing liens or encumbrances on the properties, and the Property
Appraiser is not responsible for any problems or complications resulting from this action Uwe have requested.
2. That this action will be completed by the Property Appraiser's office on a non -priority basis, "first come -first served'.
I That Uwe am/are the owner(s) of record or the legal agent for the owner(s) of record, and that Uwe may be required to
provide recorded proof of such ownership or agency. If acting as agent, written proof of agency is required.
4. That the Property Appraiser is not responsible for errors arising from errors or omissions in surveys or other
information submitted in connection with this request.
5. That Uwe have verified with the St. Lucie County Planning Department or other Jurisdictional Agency as to what
adverse effects, if any, this split/combination may have on the property.
6. If the property is mortgaged, Uwe must notify all mortgagees associated with the properties listed above.
SIGNATURE, Owner Date SIGNATURE, Agent Date
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PRINT, Owner PRINT, Agent
Mailing Address: �IUIJ�S/�2/_=
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Phone: Home Z 72- 9/h-/, 3 ;ry Work ' 472- b%311-,9991 Fax
FOR USE BY PROPERTY APPRAISER'S OFFICE ONLY
Order taken by: J li ,I, tt (, " L Z- DateJj
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