HomeMy WebLinkAboutFILLED LAND AFFIDAVIT-` SCANNED BY
S4 Lucie County
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building &Code Regulations Division RECEIVED
• 2300 VIRGMA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 MAR 0 7 2018
ST. Lucie County, Permitting
FILLED LAND AFFIDAVIT 4,a
I, the undersigned, am he owner of the following described
(Parcel Id#/Legal description/
for which I have applied to
accepting this Final Developm
that as owner of the above
7.04.01(D), St. Lucie County L
adequate drainage so that the i
I further acknowledge that in l
St. Lucie County is neither oI
adequate drainage off my pr
community.
Signature
STATE OF FLORIDA, COUNTY OF�
ACKNOWLEDGED BEFORE -ME THIS
BY
COMMISSION
SLCPDSD Revised 04/11/2011
t. Lucie County for a Final Development Permit. In
nt Permit, BP Number I acknowledge
described property, and in accor ance with Section
'Id Development Code, I shall be responsible for assuring
mediate community WILL NOT be adversely affected.
anting this permit for the development of this property,
ged nor liable to provide for, or maintain in any form,
perty which will not adversely affect the immediate
DAY OF MA L20AY—
WHO IS PERSONALLY KNOWN TO ME (ElOR WHO HAS
TYPE OR PRINT NOTARY
KAREN S. NIELSEN
'r Commission # F�Fk�$37
"s '= MY Commission Expires
June 12. 2018
�Ylllllll ��
AS IDENTIFICATION.