HomeMy WebLinkAboutFILLED LAND AFFIDAVITST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL.34982-5652
772-462-1553
PER M 11-Tjj'qG
St. Lucie county, FL
--
FILLED -LANDS AFFIDA - - -- - -- -- _ _ --. -
I, the undersigned, amhe owner gf the following described property:
(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 WII_ _L 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.
B R i A A) i L IC H .d
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
AI—LOULL
ACKNOWLEDGED BEFF�ORgE ME THIS�_ DAY OF 20-a
BY APB' 1Q kl ! iJ (1 n hJ:fWHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
li AS IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
(SEAL)
NOTARY TrME COMMISSION NUMBER
PUBLIC
l(AREN S. NIELSC- `,l
`�.�PPY VUD�CIi
°`�/ Commission FF 115637
"`*^ M Commission Exoirc.s
�, Y
���rE OF F�`���' June 12. 2018
''� �YIII TIFF � ..