HomeMy WebLinkAboutFilled Land Affidavit�J G ST. LUCIE COUNTY
.� BUILDING & ZONING
F 2300 VIRGINIA AVENUE
FORT PIERCE. FL 34982-5652
�OR`Q4` 462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
for which I 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 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.
Ar r _ 61 alz5ol7l ,Z/ /io 9
Property Owner Name Property Owner ignature Date
STATE OF FLORIDA. COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF �Li�—� , 20f
BY Q�• br4'/j1S WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE
M / 573/7 COMMISSION NUMBER (SEAL)
EuzasETHn. ouvErl
* * MY COMMISSION # DD 879314
�EXPIRES: May 22-2013
9jFOFFl de�� Bonded Thm Budget Notary Ser*es