HomeMy WebLinkAboutFilled Land Affidavit ST. LUCIE COUNTY -
=' `�a, =� BUILDING & ZONING
2300 VIRGINIA AVENUE
® FORT PIERCE,FL.34482-5652
a o 772-462-1553
- --- IL - D-- - =NDS AF's - A T._ - - -
I,the undersigned, am the owner of the following described property:
514 o---bre 1<- Oa47Z�-
(Tax ID/Legal descriptian/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.
Property Owner Name Prope Owner Signature Date
STATE OF FLORMA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS LA DAY OF Yh S t 20—n
BY Q St�X1 +P U j if O i-N WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
L. O Z•" AS IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME 7BondedThrU
ANNA MARIE GIVENS
OMZ�{§ #GG 0423
NOTARY PUBLIC TITLE � �0 �COMMISS RES:December 16.2020
" o ` Notary Public Undanv[Iters