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Filled Land Affidavit
• ��:: .�._-�,��..�:s:�,sue;:::., �7t'.�: �' ,:'�€)�'��t' . w ,• .. _ • a a i = • FOPIT P -4 m 349824.552 772462=1553 .+cy N. • it _.-....i..w,:.,.E7 '.t•3.;:-. • .it+a .. +;�- {v; r '�`;_ =;:f77Y-��tiy...5:� �• s u 's i C� >;• *•'S•S,-"i 1, the uadersigrned,am the.owneiec£the foliowing described property: Part of 3414-501--'=-17G-J- Qa6x,l B - $ on 2rat' Ran isz e 40E Iega /l ctesellpiddAddress)for which l have applied to St.,Lucile County for a Final Deui1opment Perr it. Zn acce t�ng . p this Rhal Developmetlt.Penw,DP Number ;I acAnowledge that as•ovauof the ab©ve described property,and in accordance with•Secti n 7.04.01(D),St.tucie County Land Development Code,.I si7iall be fesponsible for assuring adequate dcaa>Inge so Mat �i�e z'n mediate ccxknurtxty't L.1.6-T.be ad e�cse r afected. I farther 4clC�a Wleaige ghat in gxa i g t sperm�t,fcrti�a.d�vetoprtibn-1 efi i i-'property,St.LucieCounty'is ne t[ier•obli d rsOx tiab to pxov d far,,or iz�a Arai i in arty ft3rxn,adequate:drainage•off-my property which wilt rot'adversely a;ff�c1.due i�;cie'dlaie•bafn —77 Property Owner N=e Property Owner.Signature Date, STATE OF Frf ORmA,COWNTY'GF'St. 1mki e • 6 acrct�owR.eocEne oRlrz rs as aA OF Oc-rn��n tv.2� Sy Maw w' a .ftnim VMb4S LAsorrA Cy o�vi��To s.o v�:�to HAs nezoovc . AS 0$NTMCA-50N. s�cNa v o ..oraax TYPE OR 9Rt1`iTAme OFiloTivay (Saw ra t;�tc rt, CO $s aN:9uMJ1F9z DOROTHYANNBASKIN ;* P y COMMISSION#HH 045M , y ova EXPIRES:October2.2024 Q° PubliC llndetwtlters .FOF�?., Bonded TtwNotary