HomeMy WebLinkAboutFilled Land Affidavit04
ST. LUCIE COUNTY
BUILDING & ZONING
F v 230D VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
�ORtO� 46245M
FILLED LANDS AFFIDAVIT
1, the undersigned, am the owner of the following described property:
-)C_7-:
v9s
t I ax iwLegal aescrlpuorvRoaress)
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.
Property Owner Name
STATE OF FLORIDA. COUNTY
Property Owner Signature Date
ACKNOWLEDGED BEFORE ME THIS _DAY OF �' I U U• , 20
BY IOU— b1m 11_ ngme%z WHO IS PERSONALLY KNOWN TO ME R WHO HAS PRODUCEDyy
�' UJ �' ✓� �/ AS IDENTIFICATION. r l � Cy� ' 6 9� G �v
23
SIGNATURE O OTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE COMMISSION NUMBER (SEAL)
4�
.MMSSa H�Mp
v a1 P46/ih6 20pj �B�