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HomeMy WebLinkAboutFilled Lands Affidavit0
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Pok 1�l G s; . 34932 SGSS
. 772.4�� 1SS3
X the ultidemigapd, am t-he.owmmeof the fomw.i,:
Part Of 34Z 4-50I'-3 �0. � ::. described property:
000 $ec.tiot= 26 To .ris.iz 36:s ' &.
EKsl-9fD/ e W desc Range 4,08
g P�aoNAddxess)
thisv bat x heave pm,,, t. to. St.:uoie County for a. Rime Devpflopment Permit, in acce ti
t its ii�ai DevelOPa:lent.Pern � t, BP Nuinber P ng
the above described ro � I aekaowledge that as own"e,"o:�
P P y� and in accordance witi�.,Sectioc� 7.04.01(D), St. tueie Cod2ty
I and DevelopM, 'e'Qt Cdde,. I hall be tesponsi�ke for assuring adequate dtaa>►�a a so drat �i�e
immediate coa un ty •' L: NQ�.. big adorers:
gxan g this peirrn t for the d veha r aer� of i �px Y� sd.Lucie County' s wee �'hat i n
�aor iiabie to provi.�l• for or , bl ed
rr�ainlak a
vviii not aa��rerseiy a�•ec't ti3e xixirrtet�Z•a�e' any f oi�n, adecluata: draanage' o:� •m�Y AxQA ty vi►h ich
cbix�i�ithi'ty. �`
Hatth•e err L'vZ e - Tnivrin a .•
P.ropecty O arner NjIme ParOPOity Owner. Sigriatore Date
STATe OF FILOR OA. •COUNTY-- - t - Lmb i e
ACl!CNO'1 X.mcw 8]F01,8M TMS _ r90
8Y Ma_M e.w L 5i3 a fr0y2i33 e 9 dHOfIS PEttSi© 1f iCi O'YYi TO MB Okt 0140 WAS moDucto
AS ti7 RIT.ACAnON.
R 07N yNN �i4S�/rJ
9910NM1:U1 0F.N TYPl3 oR iAMTWM6 OFMorO jty
� (SI:AI.) • •
COMtu' WON Nf1MiBEtt
. DOROTHYANNWKIN
• ?�' MY cOMMISSION # GG 030145 .
+ r` EXPIRES: October 2, 2020
"'•'f oe'• Bonded Thal Notary Public Underwriters