HomeMy WebLinkAboutFilled Land Affidavitd
ST. LUCIE COUNTY
BUILDING'& ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
772-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of•the following described
(Tax ID/Legal desciiption/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In accepting
this Final Development Permit, BP Number 13 003mjRacknowledge 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.
Groperty Owner Name Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF i✓j L
ACKNOWLEDGED BEFORE ME THIS ° DAY OF re t u� L , . 1
BYj ®jet % i A20 �- WHO IS PERSONALLY OWN TO ME OR WHO HAS PRODUCED
'� AS IDENTIFICATION.
G
GNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TrIT R aiD $ 70 2 0 (SEAL)
COMMISSION NUMBER
NOTARY PMC•STATB .Mi
OF FLORIDA
„1iIIry,S Joann A co
Commission #DD870202
RECEIVED :,,..,,,.. ' FxpiTea: MAY 02, 2013
BONDFT��.
D.T[1RU AT IMC BONDMG CO., y �C
MAR 21 2013