HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
BY
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
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(Parcel Id#/Legal description/Addres
for which I have applied to
accepting this Final Developir.
that as owner of the above
7.04.01(D), St. Lucie County L
adequate drainage so that the i
I . further acknowledge that in I
St. Lucie County is neither oti
adequate drainage off my pr
community.
Richard A. Brown
Propert Own Na e (PI se Print)
ILoi a OL1 QAk4II b2.
St. Lucie County for a Final Development Permit. In
tent Permit, BP Number , I acknowledge
described property, and in accordance with Section
ane Development Code, I shall be responsible for assuring
mmediate community WILL NOT be adversely affected.
)-ranting this permit for the development of this property,
Iliged nor liable to provide for, or maintain in any form,
operty which will not adversely affect the immediate
a-1 —l3
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF Bred
ACKNOWLEDGED BEFORE ME THIS l DAY OF �� 20
BY Richard A. Brown WHO IS PERSONALLY KNOWN TO ME XX OR WHO HAS
PRODUCED AS IDENTIFICATION.
I
SIGNATURE OF NOKARY P B C I TYPE OR PRINT NO ARY
COMMISSION NUMBER
"Fv'�•, NMOYOOOPlf1EAL)
MY COMMISSION # SF 042597
:�- EXPIRES; Fsbrus l 1, Pb97
l,�Rf Bonded Thru No" Pubb Unktdom
SLCPDSD Revised 08/24/2010