HomeMy WebLinkAboutFilled Land Affidavit !� T
ST. LUCIE COUNTY JUL p ,R
r`" T BUILDING & ZONING �<
PLPf/F,'TTf-adz
2300 VIRGINIA AVENUE St, Lucie C.oun;y.
® FORT PIERCE,FL.34982-5652
o o 772-462-1553
_ - - FII.LED-LANDS A►-I��`IDAVIT--_--__ _-__-___-- -
I,the undersigned, am the owner of the following described proerty: b
':?U► '7 -• I r4 _ (V p?2i- 000 -0 L h '3t B 1OCTIC''1 D
(Tax ID/Legal description/Address) TwIt Vlfrec t (:::t 3ql('F%Z.
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 Owner Name Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF, Ihni
ACKNOWLEDGED BEFO "THIS _DAY OF 201�,
BY WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
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SIGNATURE OF NOTARY TYPE OR PRINT NAM OF NOTARY
(SEAL)
NOTARY PUBLIC TITLE comwsSI Nm„r!t uE$
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�,paYo'B�, KAREN S. NlELSEN
*_ Commission k FF 115637
`s s, a; My Commission Expires
Y%.,;,,;°+ June 12, 2018