HomeMy WebLinkAboutFilled Land AffidavitST. LUM COUNTY
BMIDING & ZONING
2300 VIRGIlVI:A-AVENUE,
FORVPIERCE, FL.34982-5652
712- 4624553
FILLED LANDS AFFIDAVIT
L the undersigned,'din the -owner -.of the following described property:
-
0T i o4al descnpaon/Addressj
for- which Ihave applied to St L466.Q—.t Finavelopment PermiIn acceptng,
" fora
_.
this Final DevelopinentPerrmt, BP Number. I acknowledge that as owner:of;
the above described property, and in accordance ,,W&-8ection 7:04.01(D), St, Lucie: County
Land;Developmenf Code, I shall be responsible for assuring adequate. drainage so that the
immediate On' muiiity;WlLL NOT .be advetSely affected. I further acknowledge that in
.granting this permit forth e development of this property, St. Lucie Countyis neither;obhged
Or liable to provide.for,.or, maintain m any form; adequate :drainage off my property which
will not .adversely;affec"t'tte unmediate community.
Property ;Owner &41he
STATE OE FLORIDA,;COUNM..'.OF Ux
Owner Signature
ACKNOWLWGID'BEFORE M6 TH[$ a DAY OF
BY ► 1Ji�� wHQ �`PSRSONALI Y:KNOVf�LT01V1E OR wHO HAS PRODUCED
Ac )DENMCATION.
szONA1vRE OF NOTARY
_. NOTARY PUBLIC" :,1'1TLE
BROOKE VAR
MY COMMISSION # GG 980494
EXPIRES: April 22, 2024
Bonded TAru Notary Public Underwriters
i'YPE OR PRINT NANIE'Ol? NOTARY
- . �?y9 ,cotvnvusslgNtv_[7Nit3ER
:(SEAL)