HomeMy WebLinkAboutFILLED LAND AFFIDAVITas
By
ST. LUCIE COUNTY
• _ j _ *_ BUILDING & ZONING
..^,...s-r
2300 VIRGINIA AVENUE
(5 _ FORT PIERCE, FL 34982-5652 RFC
a 772-462-1553 MAR
t °e?OMB jjn��n
St 9 'De
FILLED LANDS AFFIDAVIT44 � 4ne7t
I, the undersigned, am the owner c f the following described property:
,W 1 q— l a Z— 00 �,'➢ —000 — 5
(Tax ID/Legal description/Address)
for which I have applied to St. Lu,
this Final Development Permit, B
the above described property, and
Land Development Code, I shall
immediate community WILL N(
granting this permit for the develo
nor liable to provide for, or maint�
will not adversely affect the imm(
Property Owner Name
STATE OF FLORIDA, COUNTY OF
BY
SIGNATURE OF NOTARY
NOTARY PUBLIC TTT'T R
County for a Final Development Permit. In accepting
Number , I acknowledge that as owner of
I accordance with Section 7.04.01(D), St. Lucie County
responsible for assuring adequate drainage so that the
r be adversely affected. I further acknowledge that in
nent of this property, St. Lucie County is neither obliged
Z in any form, adequate drainage off my property which
iate community.
)&Cz z? n2l'R
Property Owner Signature Date
uC�a 2
DAY OF /-1' -fc, .2019.
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
IDENTIFICATION.
TYPE OR PRINT NAME OF NOTARY
(SEAL)
0 IJ 2- o aCOMMISSION NUMBER
{rr'i3z4,Erb
JEFF EPSTEIN
ary Public,-; State of Florida
:ommission # FF 932680
Comm. Expires Nov 3, 2019