HomeMy WebLinkAboutFILLED LAND AFFIDAVITi
-SCANNED
PLANNING i
I, the undersigned, am
(Parcel Id#/Legal descrip
for which I have appl
accepting this Final De
that as owner of the
7.04.01(D), St. Lucie C,
adequate drainage so tl
I further acknowledge 1
St. Lucie County is ne
adequate drainage off
community.
A O kv
Pr Pe er Nam7
Prqp'erty Owner Si afore
STATE OF FLORIDA, COUNTY <
ACKNOWLEDGED BEFORE ME
BY
PRODUCED
t 1
DEVELOPMENT"SERVICES"DEPARTMENT ..
Iilding & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
owner of the following described property,
71-'�'
Address)
l to St. Lucie County for a Final Development Permit. In
lopment Permit, BP Number 1�0 - 03 �( , I acknowledge
bove described property, and in accordance with Section
rlty 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,
er obliged nor liable to provide for, or maintain in any form,
iy property which will not adversely affect the immediate
S DAY OF yXj0 YI 20S
LA -WHO IS PERSONALLY KNOWN TO ME cu 1 OR WHO HAS
AS IDENTIFICATION.
A , In_ s.e U X ��--
TYPE OR PRINT NOTARY
SIGNATURE OF NOTARY PUBLIC
COMMISSION NUMBER
I<AREN S. NIELSENsE )
�� Jn'1'''IT-
_� R
Commission # FF 1156.37
My Corn mission Exp ires
�P'F
June 12. 2018
SLCPDSD Revised 04/11/2011