HomeMy WebLinkAboutFILLED LAND AFFIDAVITJ
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F
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
r 2300 VIRGINIA AVENUE
r FOR PIERCE, FL 34982-5652
CANNED (772)462-1553
BY
Q Lucie County FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/AddlFe�s
for which I have applied to St. Lu
accepting this Final Development Pe
that as owner of the above descr
7.04.01(D), St. Lucie County Land Dt
adequate drainage so that the immedi
I further acknowledge that in grantin,
St. Lucie County is neither obliged i
adequate drainage off my property
community.
Z)
��
- County for a Final Development Permit. In
nit, BP Number , I acknowledge
ed property, and in accordance with Section
elopment Code, I shall be responsible for assuring
e community WILL NOT be adversely affected.
this permit for the development of this property,
r liable to provide for, ,or maintain in any form,
vhich will not adversely affect the immediate
Property O er Name (Please Print%
I
Property Owner Signature
STATE OF FLORIDA, COUNTY OF-:Z---7-nd411
Date
v e�
ACKNOWLEDGED BEFORE ME THIS �� IDAY OF iT 1 Imo_. 20_ V ,
BY E c �( Q I I C�T� -OIIS PERSONALLY KNOWN TO ME (a OR WHO HAS
PRODUCED
v SIGNATURE OF NOTARY PUBLIC
PP-1 i S COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
I
II 1.A_.
TIfPE OR PRINT NOTARY
(SEAL)
L. RYE
401 Ilrtry Public Stele of Florida
Coetgtleeion N FF 184526
My Comm. Expires Feb 25, 2019
Bonded though National Notary Assn.