HomeMy WebLinkAboutFilled Land AffidavitST' LuCIM couNTY.
'-Bii!;&;:&ZONING
2300-VMGRq-AAVENUE
-FORT PIERCE; FL 34982-5652
772-462-1553
ILL2 LA"
1, the undersigned, am the o (:Dotvz�
owner of the following described property.
# 1
T 9 / 7 2 A I n —,v
(Tax 11)"gal
desclttiOntAddiess) northeasterly of 1-95
for which 1 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 W MIL ..N-
IL M--.0T be adversely affected. I further acknowledge that in
grallting1his petmit for the &410pment of this property, St- Lucie County is neither obliged
nor liable to providefor, or maintain in. any form) adequate drainage off my -Property which
will not adversely affect the imri ediate ciomlAunity.
............. ................ ..
Mat
PrTerty'Owfter Name Property Owner Signature Date
STATE OF M.opmA, c6uNTy OF
ACKNOWLMOMBEIFOnMETM--5RI—DAIYOlr .--J Q C'y
BY
Me —WHO IS PERSONALLY KNOWN' TO AM:OR VrMO HAS MOD11C.1l)
IDENTIFICATION.
1136
-d —.4S 1c, tj
SIGNATURE OF NOTARY
TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE
Sol (SEAL)
4%1 DOROTHY ANN BASKIN.
MY COMMISSION # GG 030145
nor EXPIRES: October 2,2020
BoMed Thru Nolary Public Underwifters