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C[E-, �1 V E D
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
311(0 Ayj 20ac-6
(Parcel Id#/Legal descril
Palm City, Fl 34490
JUL 2 1 20%
PEP;4I1_TI#\!G
St. Lucie C _,r. ,
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.
Scott Harala
Property AOr
VM e
(Please Print)
Property caner Signature Date
STATE OF FLORIDA, COUNTY OF Broward
ACKNOWLEDGED BEFORE ME THIS 19 DAY OF J 20 16
BY Scott Harala WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED
COMMISSION NUMBER
SLCPDSD Revised 08/24/2010
AS IDENTIFICATION.
Denise Brown
TYPE OR PRINT NOTARY
N
DENISF{F
=*:
Commission F 140607
Expires November 4, 2018
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