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HomeMy WebLinkAboutApplication for Zoning Compliance - Use Permit p OFFICE USE ONLY: DATE FILED:`ti Z� a PERMIT#: ;IA Cost: $55.00 PLANNING&DEVELOPMENT SERVICES BUILDING&CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft.Pierce,FL 34982-5652 772-462-1553 Fax 772-462-1578 APPLICATION FOR TEMPORARY USE PERMIT BUSINESS NAME: NAME OF EVENT: ?fG l 'f � C�1v�LC► ��V�� LOCATION AND ADDRESS OF TEMPORY USE EVENT: �L -:E) Z ,g_IDS SyS y 1 Q�� Sim �.� PROPERTY TAX IDENTIFICATION#: 391`f 'Sa( - I I �— DESCRIPTION OF TEMPORARY USE: A DA�N(rl-. 90:) n cdt+ro, - 4,aaxens Qt erre5 DATES OF THE EVENT: p,/ �'- I D -I b APPLICANT'S NAME: Colo 1 APPLICANT'S STREET ADDRESS: CITY: 0"�'� 5� I,UUSTATE: (_ ZIP CODE: WILL THE EVENT HAVE A TEMPORARY LIQUOR LICENSE:YES NO WILL THE EVENT HAVE A TENT(s):YES X—NO (up to 900 square feet exempt from fire permit) WILL THE HAVE BANNERS/PENNANTS/FLAGS?YES -& /NO (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 SIT.�LUCIE CgUNTY LAND DEVELOPMENT CODE,SEC ON 8.02.02J. IV � PRINT APPLI ANT'S NAME GNATURE F APPLICANT I STATE OF FLORIDA,COUNTY OF '� ACKNOWLEDGED BEFORE ME THIS DAY OF 20 I�, z 0 Derv,P. BYQ.�C�L� C9b�� WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUC AS IDENTIFICATION. SIGNATURE OF NOTAR TYPE OR PRINT NAME OF NOTA+ Y e ' TITLE: NOTARY PUBLIC COMMISSION NUMBER: SLCPDS 10/19/2015 NIICOLASA CRESPO �'• MY COMMISSION#FF972420 EXPIRES March 17,2020 X07 30"16 3Ww.ow PERMISSION FROM OWNER OF PROPERTY DATE: / �� b AS OWNER OF THE FOLLOWING DESCRIBED PROPERTY,I AUTHORIWE 0C 4aJqCe CA-4� r TO HOLD AUTEMPORARY USE EVENT. PROPERTY TAX IDENTIFICATION#: LEGAL DESCRIPTION OF PROPERhT� (`,�f2 Y: �� b) j cC figoU.s' oz6 2e5 � &K 3 TIM i Alf PROPERTY ADDRESS: t' �P „( � �U US/ivy 1 SA OWNER INFORMATION: PROPERTY OWNER'S NAME: F-w(dif, /mfl PJd'LG(f PROPERTY OWNER'S ADDRESS: r _ -71d 7 �+. CITY: V�},6ty CiI(5 D CD(�'N� fes/ STATE: ZIP COE:S�lv? m(CA 6( 62 PRINT OWNER'S NAME SIGNATURE OF OWNER STATE OF FLORIDA,COUNTY OF S'� Vyo—v- ACKNOWLEDGED BEFORE ME THIS DAY OF ` �M�e� 40 BY ®r,�� �'P �'�-'C^ WHO IS PERSONALLY KNOWN TO ME OR WHO PRODUCED -4 �! AS IDENTIFICATION. SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY TITLE: NOTARY PUBLIC COMMISSION NUMBER: yFQ-1ZlAa® ' NIGGLASA CRESPO ' MY COMMISSION#FF972420 EXPIRES March 17,2020 (SOT 3Y&0107 ,�, SLCPDS 10/19/2015