HomeMy WebLinkAboutPERMIT RENEWAL REQUESTFrom: Mike Heissenberg Fax: 17728710990 To: F": (772) 462-1578 Page; 2 ol 3 0310912020 10:08 AM
—ING AND DEVELOPAIENT SERVICES DEPARTryMN
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ODF- REGULATION.$ DM ...
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2300 VIRGINIA AVE
1`011T PIERCE
FL 34982.
(772)462-1553 'Fax -1578 7i�ECEIVM
(77P 462
�SCANNEID.
By VAP 0 9 Ma
St. Lucie Countv PERNUT RETSEWALL REQUEST.
Permitting
J?EMTNIJMBER:. j %
ADDRPSS:
—Oaleaa 11 �rif
:14idursuma tilat I must sch am requesting that the abo.ve permit be enewed I I
t;uuIe` cl ss all required inspections for the permit to b r
understand that fitis is a ONE TMEij?,FaW e finaled. Further, I
kL and the p
Passing inspection dur' erMit shall expiresh
Ing any six od during the renewal Quid J not receive a,
I'll per, Period.
bstification. h W Q win
c8n CUX A r-
Izz
�KA 'TOR
VA I-E
13" Name f4— _11V-A-15
STATE OF FIO .......
..........
CQUNTYOF��(AC4
ACKNOWLED'OED BEFORE NIE THIS DAYOF 2MRU0
BY M, ft�l ki�srn WHO IS PERSONALLY KNOWN TO NIE
HAS PROVIDE OR
As IDEN11. FICATiON.
STAMOF FLOMA,.C,,nV or. %%
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—Ri�NATVRE 0 �OTARY
)N T
EpUlil"o
ATE OF FLORI� A
C"
EX01re
$211712024
Folt OFFICE USE ONLY--
Numberof.0penInspections.
Total Inspectiom
de 0 P en by I c �t a I t o ge A-I-/. 0 f o p e
percentage- n inspections)
Orw1w per—'7 ......
0 open S �Renewaj fee
J . 7 . 5 (ren . e . w . aj fee),. ...... ..... .
................. ... — ... ........... .......