_____________________________________________________________________________________
Town of Lady Lake
Building Department
409 Fennell Boulevard
Lady Lake, FL 32159
(352) 751-1511
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for
Demolition of Structure(s)
I, _______________________________, the legal property owner of the below property, give authority to ____________________________ for the demolition of the structure(s) on said described property.
I hereby certify that I have fully described the property to the demolition contractor, and said contractor has complete knowledge of the structure(s) that are to be demolished.
I furthermore certify there are no mortgages or liens on said property and that I am the sole owner of said property. If there are liens, mortgages, or additional owners they have been given legal notice of this demolition.
Property described as:
Lot/Parcel: _________________________ Block: ________________
Subdivision: _________________________ Section: ______________
Township: ______________ Range: ___________ Alt. Key: ___________________
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Signature of legal property owner
__________________________________
Printed name/title of legal property owner
The foregoing instrument was acknowledged before me this _____day of ____________, 20_____ by ___________________________, who is personally known to me or who has produced _______________________________ as identification.
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Notary Signature
__________________
Date