HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES: DEPARTMENT
Building .& Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
72) (
74624553
RECEIVE
FILLED LAND: AFFIDAVIT 0 C 11:1 2 `J ; a
S7. Lucie County, Permitting
I;:the undersigned, aim the owner of the-following.described.property,
u (] I� �7 1. I 1- t �
401b0cl•V.�10 0.0' 1/1�In I-i�ey l�ta' s;Ulni1.-0:$-S O Lod 9(hP-P3y/111
(Parcel Id#/Legal description/Addr ss)
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)5 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.
-e a u sclZi-ames Crud J, .
Property Owner Na (Please:Print)
9
Pr er Sign e.. .
-Date
STATE OF FLORIDA, COUNTY OF : LllC4 e
ACKNOWLEDGED BEFORE ME THIS DAY -'OF ��� VDU 2'0
BY c, r�i S-1 I e ��QCI �CQ LJ�}NI P_S l l (1 CQ WHO IS PERSONALLY KNOWN TO ME (IS ) OR WHO HAS
PRODUCED AS IDENTIFICATION.
r4b er
SIG►NATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY .
�C5.d3 094 3 COMMISSION NUMBER:
Paula S. Breier (SEAL)
�=' Commission # GOOM
2 Expires: September IS; 2020
Bonded thru Aaron Notary
SLCPDSD Revised 04/11/2011