HomeMy WebLinkAboutFILLED LAND AFFIDAVITJ
ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
• :
FORT PIERCE, FL 34982-5652
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561-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
3q®3- 50a-03 t -eoo-7
(Tax ID/Legal descripton/Address)
for which I have applied to St. Lucie County for a Final evelo ment 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 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.
Property Owner Name Pro Owner Sign uraL Date I /�s
STATE OF FLORIDA, COUNTY OF ST L U CLIdy,
ACKNOWLEDGED BEFORE ME THIS 1 f DAY OF &BU d P _! 20D3
BY PARS 1 O I U)ig WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
PE 1_/_ y k�4610 t4 AS IDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
(SEAL)
NOTARY PUBLIC TITLE CP- 33 COMMISSION NUMBER
Linda June
White
MY COMMISSION # CC845354 EXPIRES
June 10, 2003
' r` BONDED THRU TROY FAIN INSURANC� INC,