HomeMy WebLinkAboutFilled Lands AffidavitST. LUCIE COUNTY
BUILDING & ZONING
2= VIRGINIA AVENUE
•. FORT PIERCE, FL 36982-SSS2
( 661d52-ISO
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
a3il-443 - 000t - 000-
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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.
lociEfRe y �Rpt0 MY P PRQ5 ` --�
Property
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Propertty Ownetor°r ame Property Owner Signature Date
STATE OF FLORIDA. COUNTY OF } , L G) e
ACKNOWLEDGED BEFORE ME THIS _DAY OF Y► gfLrij� , Zp
BY G e O / b WHO IS PERSONALLY KNOWN TO ME
SIGNATURE by NOTARY
NOTARY PUBLIC TITLE
TYPE OR PRINT NAME OF NOTARY
COMMISSION NUMBER (SEAL)
' OD58474
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