HomeMy WebLinkAboutFilled Land Affidavit ST. LUCIE COUNTY
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Fi -,36VIRGMAAVENUEiAY 6 17
0RTLIERCE M-34982-5652
o_ - 772-462-1553
;aS.T "FS ISK"Yvyy� _ '^.LC.'t
S'. Lucie t;ac:nty, FL
FILLED -
I,the ue i ed; am the owner of a following described property:
,to �3- m1)1-,wL�2�y
(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 122�1)tn 15 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 Property Owner Signature Date
STATE OF FLORIDA.COUNTY OF 4�l
ACKNOWLEDGED BEFORE1
ME THIS U V DAY OF�T.201—r
BY:� �
` ��� ;z Ci I bt: WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
\ 1- AS IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE rr1•�OMMISSION NUMBER (SEAL)
." WAREN S. NIELSEN
.4y'fir
�s
Commission# FF 115637
My Commission Expires
June 12, 2018