HomeMy WebLinkAboutFilled Lands AffidavitPLAAIN1NG & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, I -L 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner ofthe tollowing described property,
1319- /qt/- bQ®o - oao - o -731a =6dr-'- X1. I of,4 Pierce, FL 3'1957/
(Parcel W/Legal description/Address)
tur which I have applied to St. Lucie County for a L'inal Development Permit. In
accepting this Final Development Permit, BP Number (X13- QaL/0 , I acknowledge
that as uwncr of the above described ptuperty, and in accordance with Section
7.04_U1(D), St. Lucie County Land Develuptnerlt Code, I shall be responsible tur assuring
adequate drainage so that the immediate community WILL NOT be adversely attccted.
I further acknowledge that in granting this permit tur the development of this property,
St. Lucie County is neither obliged nor liable to provide tut, or maintain in any form,
adequate drainage Off Illy property which will not adversely affect the immediate
community.
Mall ASS oh k CX j�r�:o ,�� � P���-�,�s, LLC
—
Mall
Owner Name (Please Print)
ao
Property wne. Signature Date
STATE OF FLOKIDA, COUNTY OF
_],—Ik
ACKNOWLEEDDG�Et`BEFORE mt I HIS DAY OF A/QiV� 20_'h2,,
BY 1 �S WHO IS PERSONALLY KNOWN TO Mt ) OK WHO HAS
PDUC AS IDENTIFICATION.
KIMBERLY A HAUSER
�kGN E OF NOT I T � 1 - `
omi�nssion # QG 30u9a1
1 COMMISSION NUMBER � ��.' Of
My Gonn►missidn Expires
,�•+��0 Me 07, 2013
(SEAL)
SLCPDSD Revised 04/1 Il2U I I