HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
SCANNED FORT PIERCE, FL 34982-5652����D
BY (772)462-1553
Lucie CounW FED 0 9 2018
FILLED LAND AFFIDAVIT
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
� 30q . 501 - nis- M- 0 I2-o
(Parcel 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 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.
GA-r;,na -S l ag
Property Owner ame (PleaA Print)
2
a 201�
Property Owner Signatur Date
STATE OF FLORIDA, COUNTY OF N�, L t t e� c
ACKNOWLEDLGE-D` BEFORE METHIS-I4-k- DAY OF Ce-b'A'L0-' , 20 IF
BY �0.'fT i Y� Ca l a �j/ WHO IS PERSONALLY KNOWN TO ME (ZOR WHO HAS
PRODUCED
46�� N -?4�
SI NATURfE OF NOTARY PUB C
G 0-5 ( 1 3 9 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
JoAr4r4 M.
TYPE OR PRINT NOTARY
.,, JOANN M, RILEY
_.; CwNssim # GG 054939
Expires December 13, 2020
Bonded Tku Troy Fort Insurance 8*385•T819