HomeMy WebLinkAboutFilled Lands tj12mi �—
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ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
® FORT PIERCE,FL 34982-5652
772-462-1553 R E C El VE D MAY 2 61017
FILLED LANDS AFFIDAVIT
I,the undersign am the owl of the f_ollowin�desc 'bed property:
(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 i , 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 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.
JILL, 91, 59- i2110 � 1 Z3 f )7
Property Owner Name Prop Owner Signature Date
STATE OF FLORIDA,COUNTY OF ')I Lucie
ACKNOWLEDGED BEFORE ME THIS �.3 r� DAY OF 2d L,
BY flL Ll r i WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
Note Pubi
L/1,t1 _ 1 I/ '��l T/s' Cr Notary K State a(Fbnda
? Y Commission FF 193030
SIGNATURE OF NOTARY TYPE OR P OF PARV261 019
S
NOTARY PUBLIC TrIlE COMMISSION NUMBER