HomeMy WebLinkAboutFilled Land AffidavitCOGy
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LUCIE COUNTY
BUILDING & ZONING
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2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
F�ORIOP
561462-1553
FILLED LANDS . AFFIDAVIT
1, the undersigned, am the owner of the following described property:
0532 - !E00 - C7 O V % — C? O O
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for which I have applied to St. Lucie County for a Final Development Permit. In accepting
this Final Development Permit, BP Number — (So . 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.
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Property Owner Name Prop y O r Signature Date
Abp,71-f �
STATE OF FLiW46ft-COUNTY OF
ACKNOWLEDGED BEF)RE ME THIS ? S� DAY OF LAAA , 20-0
ByAaM(-, AnnAicnWHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
Y AS IDENTIFICATION.
SIGNATURE OF NOTARY
TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE COMMISSION NUMBER