HomeMy WebLinkAboutFILLED LAND AFFIDAVITr
SCANNED'
BY - ST:'LUCIE 'COUNTY.
r�
St Lucie Ctltltoi BUMDING & ZONING
2300 VIRGMIA AVENUE
FORT PIERCE, M 34.982-5652
772-462-1553
FILL -LE"N iS AF ID IT
I, the undersigned, am the owner of the following described property:
#13�6—� � � _nnn� _n•nn /n; •ti /� �a ��� i � i-h�� r,�f- 1�1��
(Tax ID/Legal descriptiOn/Address) northeasterly of
C,Q(-\cv,A)
I-95
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 WML NOT be adversely affected. I further ackmowledge 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 S t _ Luc
ACKNOWLEDGED BEFORE ME THIS -Z= --DAY OF CFL3 20 7
BY Ma t th _w T lea W n n A wHO IS,PERSONALLY KNOWN To ME OR wHo HAS PRODUCED
AS IDENTIFICATION.
"' IJ a �BTK y ftwN NLFS �r.J
SIGNATURE OF N TARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE
• COMMISSION NUMBER (SEAL)
9P DOROTHYANN BASKIN
MY COMMISSION # GG 030145
EXPIRES; October'2, 2020
=� Bonded Thru Notary Public Underwriters