HomeMy WebLinkAboutAFFIDAVIT - FOUNDATION ONLYPlanning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (77��b2i;,t,S7-$.
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St. Lucie County
Foundation only affidavit for residential accessory structures
Permit No.
I GcnI1 6�-0 e&jcJ J 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.
RECEIVED
MAY 2 9 2019
Contractor/Owner Builder
ST. Lucie County, Permitting
STATE OF FL n L�
COUNTY OF
The forgoing instrument was acknowledged lbeefore me
RfiS� lday of Mex 20L by
li
(Name orpers9n zf�mowleftiuA)
(Signature of Notary -Public- State of Florida)
Personally Known OR Produced Identification
`Y Type of Identification Produced C.. L
Commission No. (Seal)9-ME
S. NIELSEN
rida-Notary PublicG 207484ion # G Tresmission Expe 12. 2022