HomeMy WebLinkAboutFilled Land AffidavitI, the undersigned, ar
1,Y33 ego
ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
-462-1553
LANDS AFFIDAVIT
A the following described property:
f0to 006 S
for which I have applied to
this Final Development Pe
owner of the above descri
Lucie County Land Devel
drainage so that the immE
acknowledge that in grant'
County is neither obliged
drainage off my property v
I
-Pile, car
Property Owner Name
r'2ls O t /U • e4 S ttvy I
AnrGe r p
Lucie County for a Final Development Permit. In accepting
t, BP Number QID% - j)143_ I acknowledge that as
I property, and in accordance with Section 7.O4.01(D), St.
vent Code, I shall be responsible for assuring adequate
ite community WILL NOT be adversely affected. I further
this permit for the development of this property, St. Lucie
r liable to provide for, or maintain in any form, adequate
h will not adversely affectAhe immediate community.
xz�Flc_ 8' 6119 i
Property Owner Signature Date
STATE OF FLORIDA, COUNTY O v /'q
ACKNOWLEDGED BEFORE ME THIS /y DAY OF� 20_��
BY . 393 -COG ^�'�_CkNHO IS PERS ALLY KNOWN TO ME OR•WHO HAS PRODUCED
OF 0011(1RY TYPE OR PRINT NAME OF NOTARY
(SEAL)
NOTARY PUBLIC TITLE COMMISSION NUMBER
LORIE A. GERSTEMEIER
My COMMISSION # DD M4317
EXPIRES:February % 2010
llcUnderwrrters
' .•
BendednfuNolari