HomeMy WebLinkAboutFILLED LAND AFFIDAVIT•
�Jt',� COliy ST. LUCIE COUNTY
BUILDING & ZONING q
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t s FORT PIERCE. FL 34982-5652 F�ORtOP • 561-462-1553 �Y
ST LCCIL COUNTY
FILLED LANDS AFFIDAVIT
1, the undersigned, am the owner of the following described prop
(Tax ID/Legal descdption/Address)
for which I have applied.to St. Lucie County for a Final Development Permit. In accepting
this Final Development Permit, BP Number , 1 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:!�• \,� C�
ACK WLEDGED BEFORE ME THIS DAY OF �.� . 20��
BY t�o,`�` ` V 'k N�- —HO IS PEREWNALLY KNOWN TO ME R WHO HAS PRODUCED
` IDENTIFICATION-
SIGNATUR OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE
Kathalew A. Powell
MY COMMISSION# D0100768 EXPIRES
October 24, 2000
BONDED THRU TROY FAIN INSURANCE, INC.
(SEAL)
COMMISSION NUMBER