HomeMy WebLinkAboutFilled Land Affidavit g :.., .�: PI.,ANNIN�&1?EVELOFMEN'r SERVXCES D►EPARTMICN.
Buduag.:&Ccide2egLilahons I3�vison,
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982 5652 RECEWED
X722)462 155A
F
MAR 2 7 2017
PERMITTING.
St. Lucie County, FL
T,,the undersigned,am the.owner of the:following describedproperty;;
`ffo. fie, _o o. 1 o of l9✓`
;(Pxrcei�d�(LegaL:ilescngt►on/A.da�ress)=
for which I have applied to $t Lucxe Count fora FInaI Development Permit In,
aceeptuag this -1mal;Deveiapment Permit, BP°"Numbex �- _- _ , I acictowledge
that as ovuner' of e aliave descnbed property,; end u_ accordance wid%, 8ecto {
7:04.61(D), We County,ancl'I?evelopmenti Code;I shall be responsiU''le for assuring
adequate draw age so_that the uurnediate community WWELL.t OT lie adversely affected.
I further=:acknowledge that in granfiing dais permit fgr;the development a€th>s prs�perfy;
.at,. Lucid County is°i either:,obhged nor,'Iiable to provide=foi-, or maintain any f6ni
adequate drauage off my property which will not adversely affect; the immediate
:community;.
Nvedx-,O net Name;(P eTPrint
,roperty 0wnex S'gnaiure - Date
ACKNOWLEDGED BBFOREME THIS,. : DAY OF'.,. _�_1 ,�
B'Y' \ uY�ee.�.�. _ \-��A�GHT - WHO PERSQNALLXKNQWN"TO`ME ORVIHOTIAS'
PRODUCEDi
;SIGNATUREOFNOTARY.P_UBIIC '_ _ TYPE.OR`F1tI1VTNOTAPC
GQMMISSIOI�IIrT C7IviBE -DONNA H.BASS
Y 1����i
"'$`�' MY COMMISSION n FF 954727
EXPIRES:January 27,2020 ,
0i N�
` Bonded Thru Notary Public Unde^Hrii�t
SIGPDSDRevised 04/1-i/20i;[`
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