HomeMy WebLinkAboutFILLED LAND AFFIDAVITL� NING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
LANDS AFFIDAVIT
I, the undersigned, am thel owner of the following described property,
4-1c--'7621-- &c> --2-o-- eGo
(Parcel Id#/Legal
for which I have appl
accepting this Final De
that as owner of the
7.04.01(D), St. Lucie G
adequate drainage so th
I further acknowledge 1
St. Lucie County is ne:
adequate drainage off
community.
Iry&o I fI 1
Property O ner Name (Please
Signature
0 /4 A V
. to St. Lucie County for a Final Development Permit. In
lopment Permit, BP Number , I acknowledge
bove described property, and in accordance with Section
ity Land Development Code, I shall be responsible for assuring
the immediate community WILL NOT be adversely affected.
t in granting this permit for the development of this property,
-r obliged nor liable to provide for, or maintain in any form,
y property, which will not adversely affect the immediate
aI I I?
Dat
STATE OF FLORIDA, COUNTY OF I S 4- . Lo C i
I
ACKNOWLEDGED BEFORE ME THIS v2 DAY OF rebfL7 a-r V 20 1 5 ,
BY o ! f n (i WHO IS PERSONALLY KNOWN TOME, � OR WHO HAS
PRODUCED r L D L �S� 5 9La ' � ✓ - WO - AS IDENTIFICATION.
.�I I
� l, /
SIGNATURE&F NOTARY PUBLIC
YMMISSIONNUMBER
SLCPDSD Revised 08/24/2010
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q, ey fies�e�'
TYPE OR PRINVNOTARY
(SEAL)
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� FF912939
; a 5, 2019
(407) 398-0'S3
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