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4S1213yi. <br />'' <br />fco SFr -118a <br />�� i t trC:' et"' <br />C9 <br />t,.,a`�. r?mA I vj JFK �;trsD T Jol': A'P .l.� CA � ? 4.1 rvi l ("A X11 1) i:t:' . �, <br />G.- tiLw Ci_ih iritN1 <br />PROJECT NAME (PRINT): Schacht Affidavit of Exemption <br />Pre -application conference project name & number: Schacht 4 -Lot Affidavit of Exemption <br />Computer assigned project #._ iS D /f 7O 18.E " 7,07 .151s -p1,10: AOE- 1 -12-70(0 <br />OWNER: (PLEASE PRINT) AGENT (PLEASE PR N T) <br />Hence--SeheEht- ScAech- t('o»y yCarter Associates, inc <br />NAME NAME <br />G 100 .6 > 12th Street <br />ADDRESS <br />Vero Beach, FL 32966 <br />CITY, STATE, ZIP <br />(772) 562-5858 <br />PHONE NUMBER <br />EMAIL ADDRESS <br />Louis Schacht <br />CONTACT PERSON <br />1708 21st Street <br />ADDRESS <br />Vero Beach, FI 32960 <br />CITY, STATE, ZIP <br />772-562-4191 <br />PHONE NUMBER <br />davidl@carterassoc.com <br />EMAIL ADDRESS <br />David E. Luethje, PSM <br />CONTACT PERSON <br />SIGNATURE OF OWNER OR AGENT <br />PROJECT ENGINEER: (PLEASE PRINT) <br />NAME <br />ADDRESS <br />CITY, STATE, ZIP <br />PHONE NUMBER <br />EMAIL ADDRESS <br />PROJECT SURVEYOR: (PLEASE PRINT) <br />Carter Associates, Inc. <br />NAME <br />1708 21st Street <br />ADDRESS <br />Vero Beach, FL 32960 <br />CITY, STATE, ZIP <br />(772)562-4191 <br />PHONE NUMBER <br />frankc@carterassoc.com <br />EMAIL ADDRESS <br />Frank S. Cuccurese, PSM <br />CONTACT PERSON CONTACT PERSON <br />1801 27"' Street, Vero Beach FL 32960 <br />F;1Community DevelopmciitV PPLICATIONS1CurDev applications Affidavit of Exemption App.rtf Relined April 20/6 <br />Page 42 <br />