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(` INDIAN RIVER COUNTY <br />ECONOMIC DEVELOPMENT AD VALOREM <br />TAX ABATEMENT APPLICATION <br />To he filed in the Community Development Department no later than March 1 of the year the <br />exemption is desired to take effect. <br />I. APPLICANT INFORMATION: <br />Business Name Business Owners Name <br />--/A ei ,. �m3G <br />Address City State Zip Code <br />S A S e-zO r 2-qc O <br />Phone Number Email Website <br />Contact Person Title <br />• Letter of authorization from corporate officer if applicant is other than corporate officer (if <br />applicable, attach to completed application) <br />Business Unit's Federal Employer Identification Number: Z `; ) Q ? ~; 5:23(e <br />Business Unit's Unemployment Compensation Number: <br />Which.of the following best describes this business: <br />® New business to Indian River County <br />AQ Cxisting business in Indian River County creating new jobs <br />If an expansion, how many jobs are currently in the business? � <br />It. PROJECT SITE LOCATION: <br />Address <br />City State Zip Code <br />Property Parcel Number(s) <br />3 2'-1 9 Z;7o®o 12 OLD 0.0"OC3 <br />Current Location (if different): <br />3895 39th Square, Vero Beach, Florida <br />3 Ll <br />r r <br />32)60 <br />Address <br />City State Zip Code <br />Property Parcel Number(s) <br />(lease) <br />• Legal description and survey sketch of real property (attach to completed application) <br />• Verified statement (separate letter) naming every individual or entity having legal or equitable <br />ownership interest in the real property (attach to completedapplication <br />Attachment -2 . 1� <br />