HomeMy WebLinkAboutFilled Land Affidavit' R Vvim
ST. Lucie ounty Permitting
� it�C C,ef �r +�3�•49g2>5d52
1 '
•{t•i.�:y�i'.. •C �: ;4 a� tc4 iI z '�'.•.. Ptrd..n...,� .. ..
X the u dersag>Gted, eM &e.oW-nef of the folloEuzr�g descri3�ed pxopert : C�
Part of 34Z4-50I'�370:1 y �
$e•ctU'Wi 26 To .rts:tzi 36s ' &. Range .40E
ET. Ijoctegw desenpion/Addiess)
for vcnccj x have applie
.d to. St. l:,ucae County for a. Rival Developtx�et�t 1'exrrait, Xa acce ti
this Rhal Developmtent•Perm it, B.p M3inber p .Qg
the above descli,'b' ro .e I acknowledge that as owner -of
p Py, and in accordance wzxh,Sectzosz �.p4.01(D); St. l:ucie Coar�ty
Land Development Code,. siaa I be responsible fo c assuiring ade�iaate drama a so that bite
i+mediate cbxrirtun`
Y . OT 40 advq ely affected, X fgrth'er acl�novrrtedge that in
gcantz g lbis pextn t,for Ebedbvelbploont Ghh $:property, St. Lucie Couxrty'is n+k tt�er :tobli ed
sox liable to pcovid� far, or a
will OGt adversel affect ' �n�at xt hi arty f6ftn, ade46fi draia&ge• o ra-y p opeety *h i • h
Y the zinrtiedae
c�ntt�iEy.
Utth-ey PIG Tniezi�in�
7.
1?rope4 Owner Name Property Own& Sigt3i tare Date
STAT.60MORWA,'COUNT`iC161"' t . I CZ-e
ACTCNO'WC,SDe.W B]WOREMTrg8,� DAY OF N o Uj &—eW B
8Y �a� i"1 L? T,J T, S� 3 G: 11571'I13i ii"JFtQ'XS i?E[tSONALZIC iCI�TO'CVi 'TO'MS Oit Vi+FtO t tAS PRODfJCI:u
' A3 i`D$iVT.Ji=iOATEON. .
aymu '.0 iz OR{VOTA ty TXPB Ott i'RWT 14W4i of-KoTA y
ara�ttc x�.' tsa
DOROTHY ANN BAS IN
MY COMMISSION # GG 130145
EKPIRES:October 2, 020
EWoo Thru NoraN Public Un erwdtem