HomeMy WebLinkAboutBrocksmith Filled Land Affadavit A NTNG & DEVELOPMENT SERVICES DEPARTMENT
Building &. Code Regulations Division
23W V1RQ1NL4 AVE1,1E
FORT Pt1=.RCE,FL 34992-5652
(772)462-1553
FR E- IVE FILLED LAND AFFIDAVIT
DEC I I ZC
ST. Lucie County,
e u erslgned, arri the owner ofth[e fallowing described property,
34nQ -5S)90,tk 5,�j jA 0
{Pareel ldWl egad descripti6nkh ddress)
for which I have applied to t- Lucie County for a Final Development Furm-A. In
accepting this Final Development Permit, BP Number l acknowledge
that as owner of the above described property, and in accordance with Sectiori
7.04.01(D), St, Lucie County Land Development Code, I shall be resipon5ible for assuring
adequate drainage so that the immediate community WILL NOT bo adversely afFected-
I further acknowledge that in granting this permit for the development of this property,
t, Lucie County i5 neither obliged nor liable to pTnvide For, or maintain in any form,
adequate drainage oft" my property which will not adverse!} affect the immediate
community.
-7 me(Please Print)
r
STATE OF FLORIDA,COTINTIC OF
ACICNOWF.ErJQ;rED BEFORE.ME THIS DAY OF L] �rl�l �� 20 �!
EY C _S r WHO IS PERSONALLY KNOWN TO ME( j OX WHO HAs
PRODUCED AS TDFNTTFICATTCIN.
5[C,N 4TUl�E OF NUfrkRY T-..:C TYPE OR PROIT NOTARY
COMMISSION NUM13ER
(SEAL)
Taft F.
�rOIA�.�64
SLC PQS()Revised 04(1 1 011bL K 20
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