Fillable Phone # Email Address (Lake County Board of County Commissioners)

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Phone # Email Address (Lake County Board of County Commissioners)

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BROWSE LAKE COUNTY BOARD OF COUNTY COMMISSIONERS (FL) FORMS

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Date:
Owners Information:
Phone #
Email Address
RE: Voluntary Revocation of Conditional Use Permit No.
Dear County Staff:
Effective the date of this letter, I wish to revoke the reference Conditional Use Permit for the following
reasons:
The physical address for the subject conditional use permit is:
Sincerely,
Owner’s Signature(s)
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Phone Email Address (Lake County Board of County Commissioners)

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Completed 18 July 2020

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