HomeMy WebLinkAboutAffidavit for Religious FacilityAFFIDAVIT FOR RELIGIOUS FACILITY
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STATE OF FLORIDA
COUNTY OF ST. LUCIE
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BEFORE ME,
_)jp undersigned. authority, personally appeared
who be duly sworn deposes and says:
1. Affiant is
2. As a represent tive and agent of APvR&4 �i4ifi1i. 0u,eCh .,r
he says that zgj_905]
will not presently house a school or day care facility, and
that, if at some point in the future the me R!;t
14L4 G`1i should decide to house a school
// or
day care facility, the q eF C vv
will voluntarily pay a oad impact fee appropriate for that
use, according to the most current Road Impact Fee Ordinance
fee schedule.
3. Affiant understands that St. Lucie County is relying on the
statements made in the Affidavit in determining whetherto
issue a building permit without payment of a road impact fee.
STATE OF FLORIDA, COUNTY OF Gl.GL�
The foregoring instrument was acknowledged before me this'day
of , o " by -:Z,5"e, /&dW, who is personally
known to me or who has produced rLl P/—, as identification.
I'I'1 �la0-�00 37-fig -D
Signature of Notary Type of Print Name of. Notary
Notary Public Title Commission Number
(seal)
6N Kathleen Cielo
* * My Commission CC95902
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•�„n.e Expires August8.2004