HomeMy WebLinkAboutZoning Compliance/Use Permit ' ,fM
OFFICE USE ONLY: DATE FILED:tP- � (� PERMIT#:
Cost: $55.00
_ Er It!FED
PLANNING&DEVELOPMENT SERVICES
! BUILDING&CODE REGULATIONS DIVISION
# al 2300 Virginia Avenue
JrJIVo,�
mmw*m Ft.Pierce,FL 34982-5652 PERMITMf G
772-462-1553 Fax 772-462-1578 5t. Lucie County, FL
APPLICATION FOR TEMPORARY USE PERMIT
BUSINESS NAME: A
C C
NAME OF EVENT: C
LOCATION AND ADDRESS 4RF TE O Y USE EVENT:
PROPERTY TAX IDENTIFICATION#:
I `
DESCRIPTION OF TEMPORARY USE: �/"L/ll �(.� S LX,
DATES OF THE EVENT: VF�1�
APPLICANT'S NAME: JLGI-n5-)me rV PE G'
en
APPLICANT'S STREET ADDRESS: ` VAC lvwl4r /AL1P•I�TT
CITY: }'7 r�tL uye-1 6, _ STATE: T La i ZIP CODE:j
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WILL THE EVENT HAVE A TEMPORARY LIQUORLICE SE:YES NO V
WILL THE EVENT HAVE A TENT(s):YES NO (up to 900 s=(Only
et exempt from fire permit)
WILL THE HAVE BAN •ERS/PENNANTS/FLAGS?YES /NO 1 er 300 linear feet;32 sq ft max size)
WI )\T P
I HEREBY ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT AND AGREE TO CONFORM TO
ST:LUCIE COUNTY LAND DEVELOPMENT CODE,SECT N 8.02.0
PRINT APPLICANT'S NAME SIGNATURE OF APPLICANT
STATE OF FLORIDA,COUNTY OF W6y
ACKN��QQWLEDGED BEFORE ME THIS 3_ DAY OF �/IaU ,20
BY V4&4-AA S'OAV Z WHO IS PERSONALLY KNOWN TO ME
OR WHO HAS PRODUCED S 5(p(> &3(D I-of 6,?-90 1,AS IDENTIFICATION.
Chris�irl�Z.TWi
IGNAT OF A TYPE OR PRINT NAN&OF NOTARY
TITLE: NOTARY PUBLIC COMMISSION NUMBER: FF i3a�q y
SLCPDS 10/19/2015 otIarY.
a� C CHRISnN
`o�nr € IXP/q StSSION FG 8994
BondedgNt 12018
through 1st State Insu.ance
'1L.,
PERMISSION FROM OWNER OF PROPERTY
DATE: �N
St. I_uCie County, FL
AS OWNER OF THE FOLLOWING DESCRIBED PROPERTY,I AUTHORIZE
L� �2 •• CI,E � .�f3 -<�g 6�O HOLD A TEMPORARY USE EVENT.
PROPERTY TAX IDENTIFICATION#:
LEGAL DESCRIPTION OF PROPERTY:
PROPERTY ADDRESS:
OWNER INFORMATION:
PROPERTY OWNER'S NAME: ie/C /1.4�E/�SSliJ� �2 /vQ/� I�GTy
PROPERTY OWNER'S
) (2-/—.ADDRESS: T��� �(/GU GtI���Q/�G� �}��(
CITY: t J'Z AISE/ �L�l' STATE: ZIP CODE: v�
PRINT OWNER'S NAME S GNATURE OF OWNER
STATE OF FLORIDA,COUNTY OF ��2Tl�tJ
ACKNOWLEDGED BEFORE ME THIS DAY OF LJ Onx ,20_L 4 ,
B V /� WHO IS PERSONALLY KNOWN TO ME
OR WHO HAS PRODUCED 1�L i e L,16-e1w e AS IDENTIFICATION.
SIGNAT OF Y TYPE OR PRINT NAME OF NOTARY
TITLE: NOTARY PUBLIC COMMISSION NUMBER:
seal
UNA URIOL
f+lotary Public-State of Florida
SLCPDS 10/19/2015 s,� Commission#FF 921971
's., its W Comm.Expires Sep 27.2019