HomeMy WebLinkAboutFILLED LAND AFFIDAVITOct 01 08 11:32a p,5
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SGANNED ST. LUCIE COUNTY
-t [t,®V 4� BUILDING 8 ZONING
R-r P1EJR E. IA FL{1VENUE
FOR7 PIERCE. FT.y79B2-565Z
FrOR}OP s61.462-1553
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FILLED LANDS AFFIDAVIT
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1, the undersigned,_ am the owner of the following. described property:
000/
l-/201- �o a �— i ii - 7
0r �1 _ voo i 0/0 / 6
[fax IDILegal 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, -1 shall Ibe 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 Ievelopment of this property, St. Lucie
County -is neither obliged nor liable to provide Ifor, or maintain in any form, adequate.
drainage off my property which will not adversely affect the immediate community.
2- C W ,E_7E >o SrJpPL_y �o2r� A
Prop erty Owner Name Prol
STATE OF FLORIDA, COUNTY OF M j A M /
ACKNOWLEDGED BEFORE METHIS /� DAY OF
BY ✓/M P,4 L M C4� WHO IS P
F
f:L—GC!21J A10 c,,l AS ]DENT
10AW 7--
Iwner Signature Date
20 oe
Y KNOWN TO ME OR WHO HAS PRODUCED
TION.
• •TYPEbR PRINT NAME OF
NOTARY PUBLIC TITL1= W.�63COMMIMON NUMBER
LOURDES ALVAREZ VEGA
Wublic -State of Florida
My Commission Expires Jun 12, 2010
ova;;
Commission # DD 528363
Bonded By National Notary Assn.
Oct 01 08 11:31 a
This applic-radon is here -by made VG, : um 4__. ermit to do the work: and
if applicable, for the parmitrcd •.•cork. I certify that .o work or installa
%vork wfil he l erforrned to meet the sta ,dnr ds of all laws regulating co
nisiv be E;ecuired for-ELE'CTIUCAL, PLUTNTBLNG•, SIGNS, NVFLI
1iND AIR CONDITIONERS. ETC':., not othe.-wise includCd w:th thi
nstallatiuns ANC11"., and to obtain a certi7ica.c of capacity.
on has corntnertced prior to the issuance of a pannir and that all
sErucriDn in this jurisdiction. I understand that separate permits
S. 1?00I S, FURNACES, BOILERS, ItEATERS, TANKS,
building per:n.it applic ll.LiUil.
St. 1-al(An County rriai<es no representation that its gr?:nting of a pertnp tvi11 autnoemz ih6 persnit holder to build the :ubjzct structure
Which is in conflict any applicable Homeowner ,Association rt''?es, by)awr or any covenants that rnuy rt:�,uict or p-rohibit such
sin.tetu<<:. Please cons 1t-with: our Homeowner's Association and re iez,v your deed €or ally rest-ictians which may apply.
The; following building permit applications are exempt frorrr una I raoing a fu,.l co,kcut re-acy review: room additons, accessory
stlucturCS (ail. typos), swirnnliil P OiS, ceI7Ce:, Y:alls. signs, SCCeC. CJ9n75, UCEIitY SUhctririnnlS & accessory uses to another non-
~.zsiduatial use. �
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NOTICE TO ONVNER: 1=.41LEi1 TU RECORD A NOTICE OF CO"AMENCENIEN' T NIAl' C:I;SUL'r I3: YOUR
P Y.NG'1 V 10E FOR 1NIPRO-,'JENILNTS TO Yol,'R PROPERTY..IF YOUh';TEND TO
OBTAIN Fl\:AN<'CL\Nj3, C.O!NSULT WITH YOUR LIHINN)F-R. OR AIN A.ITORKF.Y BEFORE
l?ECOPWI`;s y'OUR 40TtCE 6F C011ylFl`:crtix�-:` r.
NOTICE TO APP.LICA-Mr: AS THE APPI.IC:AtiT FOR THIS BU'ILDIN G PERN11I7, IF 1'l-1S iVOT YOUR MGHT. TITLE,
AMD INTEREST THAT 1S SUBJECT TO ATTACHMENT; AS A CONDITION OF THIS
PERIVIIT YOU PR0111SE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED
CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT
TO ATTACHMENT.
OWN'ER'S IFIDUA'VIT: I certify that all the foregoing
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all applicable laws regul,
_ _ 1•ti
=OVYNER O -CONTRACTOR SI NATURE
�- r-
STATE OF FLO
COUNTY OF �� � _ D.Oy
The foregoing instrument was acknowledged before
me this � day of dG/�2 20 O
by
who is personally known Or has produced
-- - " IAURDES ALVAREZ VEGA
ComntissianNo. -
_���blic - State of Florida
N � - � • My Commission Expires Jun 12,201
FI�Commission # DO 528363
111M Bonded By National Notary Assn.
NOTE: TWCC(2,).SIG YATURES-ARE.REQU
TSiS BUILDING PERMIT AS AN OWNERlBU1L'
THIS APPLICATION IN THE OFFICE LISTED 0
OWNER BUILDER AFFIDAVIT WILL BE REQUI
mation is accurate at work will be done in compliance
construction zo "
Ili
CONTRAC OR SIGNA
STATE OF FLORIDA
COUNTY OF _.4114 i,n t— i7 A D a
The foregoing instrument was acknowledged before
me this 4 0-giday of
by JDS� L= ifs G 4
who is personally known has produced
Signature of
Commission No.y P
ALVAREZ VEGA
Commission Expires Jun 12,
lo ission # DO 528363
y National Notary A
51GNATUR:E MUST BE NOTARIZED. lF APPLYING FOR
ER, THE OWNER MUST PERSONALLY APPEAR TO SIGN
THE FRONT OF TffiS APPLICATION.
ED FOR ALL OWNERIBUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.