HomeMy WebLinkAboutFilled Land Affidaviti
JL`E COG ST. LUCIE COUNTY
BUILDING & ZONING
F 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
�ORio�- 561462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
for which I have applied to St Lucie County for a Final Development Permit. In accepting
this Final Development Permit, BP Number _/)-50 (p -- &3G , I acknowledge that as
owner of the above describetl 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'rthis 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.
9wbl./J
Property Owner Name Property Owner Signature Date
I
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS n DAY OF 2P
BYVC/ WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
OF NOTARY
NOTARY PUBLIC TITLE
IDENTIFICATION.
TYPE OR PRINT NAME OF NOTARY
COMMISSION NUMBER (SEAL)
I
3 .�',,,,y n`•, �, KAREN L LAVERACK
t : ° Notary PubMc
• - Staff of Ftorkla
• `M'C42ooi
' ;q 27- COmMW1on # DDZ1981
" Booked By Nakwo
I
ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
FCRT PIERCE. FL 34g62.5652
561-462.1553
FILLED LANDS AFFIDAVIT
I
I, the undersigned, am the owner of the following described property:
Win
(Tax ID/Legal description/Addres )
forwhich I have applied tolSt. Lucie County for a Final Development Permit. In accepting
this Final Development Permit, BP Number .- LC D._y 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 immeIdiate 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 or liable to provide for, or maintain in any form, adequate
drainage off my property which will not adversely affect the immediate Communit
� . Y
I �S
Property Owner Na.me I Property Owner Signature Date
STATE OF FLORIDA. COUNTY OF
GED BQFORE ME THIS
BY
J
DAY OF , Zp
WHO IS PEBSDNALLY KN0]pCNLME OR WHO HAS PRODUCED
.—�
IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE (SEAL)
COMMISSION NUMBER
KAREN LAhtA Iq(
a`
Ndaq► PubMc - >� a IF�orlda
evNaloral A.