HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 vmGINIA AVENUE RECEIVED
FORT PIERCE, FL 34982-5652
(772)462-1553 JAN 17 2018
FILLED LAND AFFIDAVIT ST. kucle Goway, mrml0no
I, the undersigned, am the owner of the following described property,
33= -a�S 06 gg - 000. 2
(Parcel Id#/Legal description/Address)
43.11 ) . 0<o it 7` (0 k
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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 /7//. 010% , 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.
(' M-71
Prop wn Name 1
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF &-1 L1it.6"g-
ACKINO� WLEDGED BEFORE ME THIS 151�h_ DAY OF _)GLn l tGL C!4 120
BY 'b�*(-ae-\ WHO IS PERSONALLY KNOWN TO ME CE-11 OR WHO HAS
PRODUCED _cVi !� l l (� V1i�- AS IDENTIFICATION.
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S NATURE OF NOTARY PUBIC-)
Ce- 156io 06 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
TYPE OR PRINT NOTARY
KRISTINE MICH�TAYLOR r° °fin=State of Florida �y Public
*= Commission # GG 155618
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My Commission Expires
October 29, 2021