HomeMy WebLinkAboutFilled Lands Affidavit2`
�JL�E C�Gy ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
s FORT PIERCE, Ft. 34982-5652
���R��p. • 561462.1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
S-t Lucie Clprkns a6 A4o B 1 K 3Pcict 6f Lois,1a,13,1 µ 4ad,16
r4 FDAF: CoPlM RT AtW Cor Lo-r C3 Br.K 3 ST S'61/ US -Hwy1 S-+ Lu&e
(Tax ID/Legal description/Address) Ft-- 34 9 Sa
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 provide for, or maintain in any form, adequate
drainage off my property which will not adversely affect the immediate community.
_ o s
Property Owner Name Property Owner Sign ture Date
A I et
STATE OF �F,, COUNTY OF J7eFR r300
ACKN JOW�LE�D�GQE�D BEFORE M� EQTHIS I34-'" DAY OF , 2005
BY f7w "N V. �IGiQX4U WHO IS PERS ALLY KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
40,16 Loura
SIGNATURE OF NOTARY TYPE OR PRINT NAM OF NOTARY
/or /of
(SEAL)
NOTARY PUBLIC TITLE COMMISSION NUMBER