HomeMy WebLinkAboutFilled Land Affidavitl
ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
772-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
3VIV IM /W08 gm 9
(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 providefor, or maintain in any form, adequate drainage off my property which
will not adversely affect the immediate community.
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF C1f )(-jfY 1
ACKNOWLEDGED BEFORE ME THIS f- DAY OF 3l 1-n I1 , 200 !�
BY 1 f i) n-'510- Lt WHO IS ERSONALLY KNOWN ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
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SIGNATURE OF N ARY TYPE OR PRINT NAME OF NOTARY
(SEAL)
NOTARY PUBLIC TITLEL6(-073 COMMISSION NUMBER
F".
7WENDY M. GRINNELLublic, State of Floridasion No. DD 687313ro Notary Pub00 Undarw0dws