HomeMy WebLinkAboutFilled Land AffidavitD
C�Gy
LUCIE COUNTY
�JL�E
ST.
BUILDING & ZONING
2300 VIRGINIA AVENUE
FORT PIERCE. 82-5652
F
LOR�O
E 1553
FILLED LANDS- AFFIDAVIT
I, the undersigned, am the owner of the following described property:
oz7y�1 /-/ us-/
(Tax ID/Legal descrip6orr/Address)
for which 1 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.
F"ne 9e,1 Core
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA. COUNTY OF
ACKNOWLEDGED BEFORE ME THIS_ JP__ DAY OF i &V I ZO �
WHO IS PERSONA - KNOWN T ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
SIGNATURE OF ARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE
COMMISSION NUMBER (SEAL)
p�Dtal� g.1i11�!? OA� OR'1
Nq0
M`I GOP S`MaP deiwd�oYs
EX Notary