HomeMy WebLinkAboutFilled Land Affidavity=
ST. LUCIE COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
2300 VIIRGIRIA ANIM E, ROOM 201
FORT P113=, FL 34152-5652
407-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,.
/D Ir Sl S D c y r / J� u Ste- , ���'. 3 11iS ---7
(tint ID/legW description/address)
for which I have applied to St. Lucie County for a Final Development Permit. In accepting
this Final Development .Permit, BP Number 61,W& UCH 3 . 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.
Aaytw Cye fs m i*o Z,, �- / —
Property Owner Property Owrn Dale
(PrIn9 (Signature)
STATE OF FLORIDA, COUNTY OF Lyl C I p
THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS c5W DAY OF 19 96
WHO 6 PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE COMMISSION NUMBER
SLCCDV FORM NO.: 011-M