Residential Application for DCA Approved Sheds

GENERAL INFORMATION

Application Date Application Number (for office use only) Applicant Name (please print):

Property Owner’s Name: Phone

Property Owner’s Address:

Site Address:

Block: Lot:

SHED INFORMATION

______Dimensions______(max size 160 sq ft in area) Type of Shed Type of Flooring

Applicant’s Name (please type or print Applicant’s Signature

Provide one (1) copy of the following:

 Site plan showing shed location on property *per FS489.5 (21) exemption

 Certification letter from DCA for approved Shed *per FS489.5 (21) exemption

NOTE: Shed must have approved DCA # affixed to the unit. NOTE: Concrete slab for shed is permitted separately.

Issued by Date:

FEE: $ _26.00

F-DCD-1028 Page 1 of 1 DCA Approved Shed Application 06-20-13 LAK