HomeMy WebLinkAboutFilled Land Affidavit RECEIV'—TD FEB 0 o 21017
!� ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGMA AVENUE
FORT PIERCE,FL 34982-5652
i r� to 772-462-1553
FILLED' • ' `. AFFIDAVIT
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t I, the undersigned, am the owner of the following described property: \ ';ZN
#1301 111 0001 OOQ 5; FaGfi z of lac-fiinn 1 tnWnShjM4S Range 39E,
(TaxM/L--galdescrip[ion/Address)lying N&W of Turnpike Feede
j= 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
!I 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.
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Property Owner Name Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF S fi _ T,u r i P
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ACKNOWLEDGED BEFORE ME THIS —7 _ DAY OF /:�176 4C4& V ,20L?
i` BY 01RT�EIrJ GF W YNdV ' WHO IS PERSONALLY MDOW TTO ME OR WHO HAS PRODUCED
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AS IDENTIFICATION.
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SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
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(SEAL)
NOTARY PUBLIC TITLE
DOROTHYANN BASKIN
MY COMMISSION#GG 030145
�• pc EXPIRES:October 2,2020
Bonded Thru Notary Public Underwriters
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