HomeMy WebLinkAboutFilled Lands ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
® FORT PIERCE,FL 34982-5652
o _ e 772-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
11 dla"Dg12 A VE. F T 2IERd E, EL. 34191
(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 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.
it-IP 1�1, IA-TAROW1CZ 7Y1.
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF b 1111
INOWLEDGED BEFORE ME THIS CDA DAY OF 20_1
BY WHO IS PERSON Y KNOWN TO ME OR WHO HAS PRODUCED
IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
(SEAL)
NOTARY PUBLIC TITLE COMMISSION NUMBER
LASHAHNAINGRAM
?" *�; Notary Public-State of Florida
o, MY Comm,Expires Dec 20,
%,'� F�dr,. Commission 2018
�' ""��� Bonded through Nato at Notary Assn,