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i L i Uamrzr 0.? r r fr.1= .:t? 1 j\T !?ORPI <br />PROJECT NANO (FLirpr7): Rey Shelin 3 -Lot Affidavit of Exemption <br />Pre-app1.catione"e ra" ct name & uunbor: „fot,1100figi jf a , atema <br />Computer assigned praje t#: AVM 1,Da/40 WO? Plan A013. t 8-09-013 <br />OWNER: (PLEASE NT) <br />Raymond W. Sheltra <br />NAME <br />6.825 49th Sweat <br />ADDRESS <br />Vero Beach, FL 32967 <br />Crt ` , STATE, M' <br />(772) x.3-81 61 <br />PIENv,:Il <br />ay a@sheitracontracting.com <br />EMAIL ADDRESS <br />Raymond Sheltrs <br />CONTACT PERSON <br />AGENT (?LEASE PRINT) <br />NAmE <br />ADDRESS <br />CITY, STATE, ZIP <br />PHONE NUMBER <br />EMAII, ADDRESS <br />CONTACT PERSON <br />PoJ4 C-4 CS-11-1-atfi <br />U SIGNATURE OF OWNER OR AGENT <br />PROW"' ENCU' ER: (PLEA ERNI) <br />Caller Asso-C ates; inc. <br />NI -2M <br />1706 21st Street <br />ADDRESS <br />Vero Beach, FL 32960 <br />cnY,STATE, zip ._ <br />(772)5624191 <br />PROJECT SURVEYOR: (PLEASE EMIT) <br />Care Associates, inc. <br />NAM3 <br />1708 21st Street <br />ADDRESS <br />Vero Bach, Fl_ 32960 <br />CTr'Y, STATE, EP <br />(772)562-4191 <br />PHONE NUNDt PHONE NUDZER <br />johnb©crteFasso .co davidU©c rterassoc.com <br />EMA , ADDRESS E isAE. ADDRESS <br />John i- . Slum, P.E. David E. Luethj , PSS+ <br />CONTACT PERSON CONTACT PERSON <br />130127'" Steel, Clem Beaoi FL 32950 <br />F:itas acnityDswelopmenlAPRICA :pp1kit I all AAid avkaPEsc trcaApp.KP Ref iemdArt 12016 Page 1 <br />coATTACHMENT <br />1 <br />