HomeMy WebLinkAboutFILLED LAND AFFIDAVITn�
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BY
3T Wc'.w:' C, �
ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
561-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
(Tax ID/Legal'description/Add(ess) — ' - . -1
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 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--\ `�
ACKNQWLEDGED BEFORE ME THIS _DAY OF 204
BY ?C*"Z
AS
SIGNATU OF NOTARY
NOTARY PUBLIC TITLE _
Kathalew A. Powell
MY COMMISSION# DD160768 EXPIRES
00ber24, ao06
0()NDED TNRU TROY FAIN INOWANGE, INC.
IS PERSONALLY KNOWN TO AXOR WHO HAS PRODUCED
TYPE OF2 PRINT NAME OF NOTARY
(SEAL)
COMMISSION NUMBER
KathalW A. Powell
MY COMMISSION# DD180768 EXPIm-
BONDED TH U TROY FAIN INSURANcL