HomeMy WebLinkAboutFilled Land Affidavit EC V-7 D
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ST. LUCIE COUNTY APR 2 6017
BUILDING &ZONING
2300 VIRGINIA AVENUE PERta177itqG
® Cal FORT PIERCE,FL.34982-5652 St. Lucie County, FL
o n 772-462-1553
STT� :
_ - D_LAI~NDS--AFFIDAVIT--- -- ---
I, the undersigned, am th owner of the olio g scribed pro erty:
112 _� i s�iy s�-�,c 1��. �n !';r:�2 l- �1.
(Tax ID/Legal description/Address)
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 WML 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.
C L. 0 6p
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS 2-1a—DAY OF 66 1 MA
BY , 1 C. c IS 4Q0-B L _WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
Y U AS IDENTIFICATION.
O—
SIGNATURE OF NOTARY 'TYPE OR PRINT NAME OF NOTARY
I
NOTARY PUBLIC TITLE FC4
r- 1 COMMISSION NUMBER (SEAL)
1<AREf�I S, NIl LSEN Jl�
11 5537
_-. Commission+% FF �.
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NAY Commission Expires
"r June 12, 2018
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