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Location Affidavit
St Lucie County, Public Works Department
Code Compliance Division
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Property ID » _ Build:ne Permit #
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SCANNED
BY
St. Lucie County
Owner's Name ICySSEw 3 fj-0T—U-ilde address Sal( /f9Le o Pj veS Cir1e(¢
roar /oit*zeB, OCc. 7114s/
1 attest to the fact that a structure was located in the exact location where I
plan to reconstruct due to damages caused by the storms. I will not build
any structure larger than what was in place prior to the storms. I will meet
all setbacks that the County requires,for the community. I understand that
any violation my cause uze to remote or relocate any structure that is in
violation of the setback' requzirernents.
Print Name: �ySsi u a ,i7�a�GL-�+a r R(=
Signature
Homeowner
STATE OF FLORIDA CO,?Jr; I Y OT- � � � Cl_e— _The foregoing acknowledged before me This day o; _ D it strumen, ,was
ers rai;v k —, 20 2 h} I� STOTTLEP?/R , Who is
P� me or who has produced as identification.
Srsr.am:coFtbfary �---------
7,.•pr ar Aar; rte� c� t':z?sc;r
Commission ?v�ellssaR@uiaones O'k- AU �i cOIDIDtsd=*DDIM370
y, caExpim MMh 21. 2006
(Seal)
4{�ae`,� Boaded Chm
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