HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, Fl, 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
- 000-
(Parcelld#/Legal
for which I have applied to St. Lucie County fora Final Development Permit. In
accepting this Final Development Permit, BP Number Ig12- 0355 , 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.
[3ryarl amc
Property Owner Name (Please Print)
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Property ignature Date
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STATE OF FLOP-IDA. COUNTY OF O G I YI f I 'If t I 'f
ACKNOWLEDGED BEFORE ME THIS O DAY OF jrig Mary 20 'LO
BY_ Brw ri racl a ms
WHO IS PERSONALLY KNOWN TO ME (iL 1 OR WHO HAS
PRODUCED 11�--11 I ` ^ AS IDENTIFICATION.
-I� RILN PI DOv V V ( NJDH
S NATURE O (IT PUBLIC TYPE OR PRINT NO Y
G6%094W COMMISSIONNUMBER
SLCPDSD Revised 04/11/2011
(SEAL)
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulatiolis Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
—, (772) 462-1553
I DFC 17 FILLED LAND AFFIDAVIT
n`� I
ST. Lucie County,
I, the undersigned, am the owner of the following described property,
(Parcel
for which I have applied to St. Lucie County for I 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.
A//ZI/aM Allag Adairs
Property Owner Name lease Print)
\ I
Proper gnatur, D [e
STATE OF FLORIDA, COUNTY OF 15ar"f UCI
ACKNOWLEDGED BEFORE ME THIS DAYOF ffij&mb2lr 20 Z9
BY illi RVt/Q✓1 y
AG�m S WHO IS PERSONALLY K_OWN TO ME (�) OR WHO HAS
PRDDI If Fn �
IGNAT/URE OF NOTARY PUBLIC TYPE
`//�jf�/ / '^� COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
IDENTIFICATION.
(SEAL)
PATRICIA ANN GRIFFIN
MY COMMISSION # OG137624
"•:?p y EXPIRES September26, 2021
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