HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
By
PLANNING &DEVELOPMENT SERVICES DEPARTME
°ucie County
Building & Code Regulations Division
2300 VIRGINIA AVENUE
w_ FORT PIERCE, FL 34982-5652
RECEIVED (772) 462-1553
MAY 0 2 2018 FILLED LAND AFFIDAVIT
ST. Lucie Co4nty, permitting
I, the undersigned, am the owner ojfthe following described property,
1J4a3 -6la4o - goa - ooa -8'
(Parcel Id#/Legal description/Address)
for which I have applied to St.
accepting this Final Developmen
that as owner of the above d
7.04.01(D), St. Lucie County Lan
adequate drainage so that the imr
I further acknowledge that in gra
St. Lucie County is neither oblig
adequate drainage off my prop
community.
f � percc, FZ 321 fq 9
Lucie County for a Final Development Permit. In
Permit, BP Number , I acknowledge
scribed property, and in accordance with Section
Development Code, I shall be responsible for assuring
;diate community WILL NOT be adversely affected.
Ling this permit for the development' of this property,
I nor liable to provide for, or maintain in any form,
ty which will not adversely affect the immediate
�w7Q;
r Name (Please Print)
,
per Owner Signature
STATE OF FLORIDA, COUNTY OF 5+, LU C_),e—
ACKNOWLEDGED BEFORE ME THIS
BY
PRODUCED
_�3
Date
DAY OF Janue!f 20 a
WHO IS PERSONALLY KNOWN TO ME L—) OR WHO HAS
AS IDENTIFICATION.
_ I
'u%L�al�,Q.Qt?�. � �r►sf,Yic. r'ch�IL¢ ILtulvY
S NATURE OF NOTARY PUBLIC U TYPE OR PRINT NOTARY
CG I5%18 COMMISSION NUMBER
KRISTINE MICHE L YLOR
State of Florida -Notary Public
Commission # GG 155618
�12 OF
My Commission Expires
SLCPDSD Revised 04/11/2011 ann+ October 29, 2021