HomeMy WebLinkAboutFilled Land AffidavitST. LUCIE COUNTY
;.3 DEPARTMENT OF COMMUNITY DEVELOPMENT
2300 VIRMZA AVZMM, ROOM 202
PORT Pxm=, n 34982-5652
407-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(ta ID/legal dewriptiorVaddrm) '
for which I have applied to St. Lucie County for a Final Development Permit. In accepting
this Final Development Permit, BP Number ?6 os-a. q V -) 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 Properly Owner Date
(PrIf) (Signature)
STATE OF FLORIDA, COUNTY OF ST• loc'&
THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS 14 DAY OF mAY .19 W
WHO PERSONALLY MOWN TO ME OR WHO HAS PRODUCED
NOTARY PUBLIC TITLE
ITC —
TYPE OR PRINT NAME OF NOTARY
AS IDENTIFICATION.
C"'O(' 010 COMMISSION NUMBER
277�/.
(»•n
"I
JEFFREYJANOCSKO
My Commission CCSMIO
wr of Expires Dec. 29,1999
9lFOF Fl��`
SLCCDY FORM NO.: 011-M