HomeMy WebLinkAboutFilled Land Affidavit ST. LUCIE COUNTY Iv
BUILDING & ZONING
2300 VIRGINIA AVENUE FEB 13 2017
® FORT PIERCE,FL.34982-5652
772-462-1553 PEMMITTING
} St. Lucie County, FL
FILLED LANDS AFFIDAVIT
I,the undersigned, am the owner of the following described property:
SOS 3 S 3 9A 5# a Pori P:eree a PG ?'1211
(Tax ID/Legal description/Address)
for which I have applied to St.Lucie County for a Final Development Permit. In accepting
this Final Development Permit,BP Number ,I acknowledge that as owner of
the above described property,and in accordance with Section 7.04.01(D),St.Lucie County
Land Development Code, I shall be responsible for assuring adequate drainage so that the
immediate community WILL NOT be adversely affected. I further acknowledge that in
granting this permit for the development of this property,St.Lucie County is neither obliged
nor liable to provide for,or maintain in any form,adequate drainage off my property which
will not adversely affect the immediate community.
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Property
-`13-17Property Owner Name Property Owner Signature Date
STATE OF FLORIDA.COUNTY OF--A= -Ll-0)If,
ACKNOWLEDGED BEFO ME THIS DAY OF 20 ..1
BY WHO IS PERSONALLY KNOWN TOME OR WHO HAS PRODUCED
_ A5 IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
KAREN S. NIELSE (SEAT.)
NOTARY PUBLIC ;o`*`Y p°�',�., �O SSION NUMBER
=� Commission 7
_. *r
i, of My Commission Expires
°fFJune 12, 2018