HomeMy WebLinkAboutFilled Land AffidavitST. LUCIE COUNTY
r BUILDING & ZONING
F 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
�ORIo�` 462-15W
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
(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 ��yl'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.
i
ne 0" Cor - ! l / �
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA. COUNTY OF �
ACKNOW EDGED B FOR ME THIS _W DAY OFJ .2a
BY / WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
/--.�.33 - {i �� —Q AS IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE i•_bANE RN
l.bGEi (SEAL)
EXPIRES: October 16, 2009
Bonded Thru Notary Public Underwriters