HomeMy WebLinkAboutFilled Land AffidavitU
ST. LUCIE COUNTY DEC 2 O 2017
BUILDING & ZONING PE'RNIITTIt4G
2300 VIRGINIA AVENUE t• Lucie COLjn4l, FL
FORT PIERCE, FL 34982-5652
772-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:I �q
3427-111-0002-000/5
(Tax ID/Legal description/Address)
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.
Property Owner Name
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF �! LLA LL L
ACKNOWLEDGED BEFORE ME THIS l� DAY OF C C Ep EX , 20
BY / f -4 rrNEW IrY�E W`i✓NNG' WHO IS PERSONALLY KNOWN TOME OR WHO HAS PRODUCED
SIGNATURE OF N TARY
NOTARY PUBLIC TITLE
IDENTIFICATION.
TYPE OR PRINT NAME OF NOTARY
(SEAL)
DOROTHYANNBASKIN
MY COMMISSION # GG 030145
.?, EXPIRES: October2,2020
Bonded Thru Notary Public Underwriters
DEC 26 2VI?
L
Unty, FL
Im'-witf-A Oft-l-ww. _W_. il'": , , , -
1! I Ml Wind6ws'8_Doprs
650 West Mar et St.--
Gratz.
80.0) 876-0643