HomeMy WebLinkAboutFilled Land Application--- PLANNING & DEVELOPMENT SERVICES.DEPARTMENT .
Building & Code Reglilations. Division f`a�
2300- VIRGINIA AVENUE. R E C.� I. Y E D
F . IERCE, FL 34982-5652
ORT P p�
(772) 462=1553 -OCT 0 . 2u 17
PERM1171NG
;FILLED LAND AFFIDAVIT St. Lucie County, FL
1, the undersigned, am the owner. ' f the following described property,
(Parcel Id#/Legal descra)tion/Address)
q,22
:. c3t-1
for -which I have applied to St: Lucie. County for . a Finial ;Development :Permit: In
accepting this Final -Development Permit, BP .Number I' acknowledge
than as .owner of the :above described. property, -arid in . accordance with :Section
7:04.01(D),. St, Lucie:County. Land: Development Code,":I shall :lie responsible for assuring.
adequate drainage so that the immediate=community: WILL -NO •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. .
Prope Owner Name Please Print)
,Properly Owner Signature Dat .
STATE OF FLORIDA, COUNTY OFWd( Q � Q�(
ACKNOWLEDGED BEFORE MET IS - DAY OFy v' .120
BY
ow
��1L yr WHO IS PERSONALLY KNOWN TOME (_) OR WHO HAS
PROD. E �— AS IDENTIFICATION.
SIGMA OF NOTARY PUB IC TYPE ORTRINT NO Y
COMMISSION NUMBER
(SEAL)
Cram Emmette MacCoy
MOTARY PUBGC
STATE pF FLORIDA
SLCPDSD Revised 04/11/2011 COt11m#99Wi
WExP1=6/2=20