HomeMy WebLinkAboutZoning Compliance/Use Permit OFFICE USE ONLY: DATE FILED: PERMIT#: Oq 11)
Cost: $55.00
PLANNING&DEVELOPMENT SERVICES
BUILDING&CODE REGULATIONS DIVISION
2300 Virginia Avenue
'COUNT�
f L 0 R I n Ft.Pierce,FL 34982-5652
772-462-1553 Fax 772-462-1578
APPLICATION FOR TEMPORARY USE PERMIT
BUSINESS NAME:
NAME OF EVENT:
LOCATION AND ADDRESS OF TEMPORY USE EVENT: -7 3 S-0 S 41,
PROPERTY TAX IDENTIFICATION
DESCRIPTION OF TEMPORARY USE:
DATES OF THE EVENT:.
APPLICANT'S NAME:_LAY,% 4ri I v Com, c)
APPLICANT'S STREET ADDRESS: =0 k Bo
CITY: � U. �CA .— STATE: ZIP CODE:
WILL THE EVENT HAVE A TEMPORARY LIQUOR LICENSE:YES-NO 11:3
WILL THE EVENT HAVE A TENT(s):YES 4 NO_(up to 900 square feet exempt from fire permit)
WILL THE HAVE BANNERSMENNANTS/FLAGS?YES—INOK (Only 1 per 300 linear feet;32 sq ft max size)
I HEREBY ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT AND AGREE TO CONFORM TO
ST.LUCIE COUNTY LAND DEVELOPMENT CODE,SECTION 8.02.02J.
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PRINT APPLICANT'S NAME SIGNATURE OF APPLICANT
STATE OF FLORIDA,COUNTY
ACKNOWLEDGED BEFA)RE ME THIS DAY OF ,20
0,
BY WHO IS RSONkLLY KNOWN TOME
OR'WHO HAS PRODUCED 03 Aj AS IDENTIFICATION.
SfG9ATURE OF NOA Y TYPE OR PRINT NAME OF NOTARY
TITLE: NOTARY PUBLIC COMMISSION NUMBER:
SLCPDS 10/19/2015
LPsVjPVANA INGRAM
Notary public.state of Florida
Z10 0 , M M.Expires Dec 20,2018
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Issi 41 FF 177249
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through National Notary
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PERMISSION FROM OWNER OF PROPERTY
DATE:
AS OWNER OF THE FOLLOWING DESCRIBED PROPERTY,I AUTHORIZE
TO HOLD A TEMPORARY USE EVENT.
PROPERTY TAX IDENTIFICATION#:
LEGAL DESCRIPTION OF PROPERTY:
PROPERTY ADDRESS:
OWNER INFORMATION: fl
PROPERTY OWNER'S NAME: '
PROPERTY OWNER'S ADDRESS: ?`�
CITY: ` STATE: ZIP CODE:
PRINT OWNER'S NAME SIGNATURE OF OWNER
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED
�,BEFORE ME THIS C DAY OF
V�
BY 1y 24n 1 C u_% WHO IS PERSONALLY KNOWN TO ME
WHO HAS PRODUCED AS IDENTIFICATION.
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TGNATURE OF NOTARV TYPE OR PRINT NAME OF NOTARY
TITLE: NOTARY PUBLIC COMMISSION NUMBER:
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SLCPDS 10/19/2015 Wary Public St2te Of Florfde
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' Date: Receipt#: Planning Tech: Permit#:
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PLANNING &DEVELOPMENT SERVICES DEPARTMENT
COUNTY BUILDING &CODE REGULATION DIVISION
- 2300 VIRGINIA AVENUE
FORT PIERCE,Fl,34982-5652
772-462-1553
APPLICATION FOR PROMOTIONAL FLAGS,BANNERS,&PENNANTS
1. LOCATION/SITE ADDRESS: V S 1
2. PARCEL ID NUMBER:
3. DISPLAY PERIOD START DATE:
DISPLAY PERIOD ENDING DATE: I
TOTAL NUMBER OF DAYS:
NUMBER OF BANNERS/FLAGS/PENNANTS: �+
*Only 1 banner per 300 linear feet. Each banner is limited to 32 square feet in sbx. Must have more than 300 feet of
linear frontage to qualify for an additional banner
4.. OWNERS INFORMATION 5.APPLICANTS(INFORMATION
Name: (�t G��'4�'1 f�si •c v Name: �i(JIip4-•"� „�. I�c'G c C)
Address:/,!507 ^1 a I��r Business Name:
City: ?S �— State: �—J Address: -7 3 S O
Zip:-,2 Phone: � '7 2^3 -y 730 City: TS L State: F -
Zip: 3 q0tg Phone: -7721-3 qOV 730
OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in compliance
with all applicable laws regulating construction and zoning.
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PRINT OWNER OR AGENT NAME SIGNATURE OF OWNER OR AGENT
STATE OF FLORIDA,COUNTY OF
THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFOTHIS-'` DAY OF to 20_,BY WHO
I RSONALLY KNO BY ME OR WHO HAS PRODUCED R � M DOC-927'03.303 -O AS IDENTIFICATION.
G TURE OF NOTARY VUBLIC TYPE OR PRINT NAME OF NOrARY PUBLIC (seal)
COMMISSION NUMBER
NOTE:ACCORDING TO SECTION 9.01.02(C),ST.LUCIE COUNTY LAND DEVELOPMENT CODE,NO MORE THAN(4)PERMITS PER YEAR
SHALL BE ISSUED TO ANY ONE PARCEL OR COMMON DEVELOPMENT SITE F LMMA MAL OF SUM(60)CALENDAR
DAYS PER YEAR. LASHAHNA INGRAM
r; Notary public_State of Florida
My Comm.Expires Dec 20,2018
Rev:11/l5/Z014 %1 Commission#FF 177249
''4 "` Bonded through National Notary Assn.
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Please identify where your place of business is located on the diagram below.Please identify the street
that the building faces. If the property abuts more than one street,please Identify all street locations.
(See sample drawing below)
North
Please show where the banner(s),flags,or pennants will be placed on the property(see example below).
Example Only
North
nnotiolw
along S Us 1
Frond of
Building
Please Note:
According to Section 9.03.00 F&G,of the St.Lucie County Land Development Code,NO display may be
located over or on any public right-of-way; or placed or attached upon any utility pole,street light,
sidewalk,curb,fire hydrant,bridge or public property.