HomeMy WebLinkAboutFILLED LAND AFFIDAVITJL�£ COG. ST. LUCIE COUNTY SGANNhu
�= BUILDING & ZONING
2 V cr=, q AVENUE Lucie �oMy
FORTT P PIERCE, FI.34982.5652
567.462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
4-2 b1 •— 11\ -- OW 000 / !1 11 SIB .d�
(Tax ID/Legal descriptiordAddress)
for which 1 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. 1 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.
TI`im Umrr �ur 7IDg
C,.e� - 4E- S. P p I `t o, p .
Property Owner Name P o erty Owner Signature Date
STATE OF FLORIDA, COUNTY OF iQ �7
ACKNOWLEDGED BEFORE ME THIS ? DAY OF 13P--0l9-.E'-�_.20�
BY Sim WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
le h o to N AS IDENTIFICATION. ;spy Pr, c
Catherine Guillar>mod
commission #DD359538
, p Q Ex ups; NOV. 14, 2003
ed. Thru
" n;,�,,,•�` Atlaaric Boa g
o, Inc,
SIGNATURE OF N AR TYPE OR PRINT NAME OF NOTARY
(SEAL)
NOTARY PUBLIC TITLE COMMISSION NUMBER