HomeMy WebLinkAboutFILLED LAND AFFIDAVITQ
I, the undersigned, am the
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for which I have applied to St.
this Final Development Permi
the above described property,;
Land Development Code, I sh
immediate community WILL
granting this permit for the de
nor liable to provide,for, or m
will not adversely affect the * I
Property'.Owner Name
STATE OF FL-ARIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS
BY
SIGNATURE OF NOTARY
NOTARY PUBLIC TITLE
ST:'L,UCIE COUNTY
BUILDING & ZONING.
2300 VIRGII U AVENUE R�FNFO
FORT PIERCE; M 34982-5652
772-462-1553 P 'gyp# 2.$ �p�g
��,����� es ,tin Dept en
ANUS � US lid `FIDA-� oust r
of the following described property: \,-,j-,;ZN (,--,X�` Q
714 10 .11 4-ti, - --s-
JD/Legaldescrip6on/Address) northeasterly of I-95
.ucie County for a Final Development Permit. In accepting
BP Number , ' , I acknowledge that as owner of
id in accordance with Section 7.04101(D), St. Lucie County
1 be responsible for assuring adequate drainage so that the
JOT be adversely affected. I further acknowledge that in
Qpment of this property, St. Lucie County is neither obliged
stain in any form, adequate drainage off my property which
iediate community.
Property Owner Signature Date
Pb /V
_ DAY OF 20—d
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
TYPE OR PRINT NAME OF NOTARY
(SEAL)
COMMISSION NUMBER
DOR==b22
MY COM0145
. , = ExPI20
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