HomeMy WebLinkAboutFILLED LAND AFFIDAVITBY
St Lucie County
PLANNING &
I, the undersigned,'am the c
1601 �Isl
(Parcel Id#/Legal description/11
for which I have applie(
accepting this Final Devc
that as owner of the E
7.04.01(D), St. Lucie Cou
adequate drainage so that
I further acknowledge thz
St. Lucie County is neitb
adequate drainage off n
community. i
TLOPMENT SERVICES DEPARIMENT'
ig & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FELLED LAND AFFIDAVIT
of the following described property,
to.St. Lucie County for a Final Development Permit. -In
)pment Permit, BP Number . I acknowledge
:)ve described property, and in accordance with Section
y Land Development Code, I shall be responsible for assuring
ie immediate community WILL NOT be adversely affected.
in granting this permit for the development of t ' his propertyj
obliged nor liable to provide for,.or maintain in any form,
property which will not adversely affect the immediate
. Adp'v towIN
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF b
ACKNOWLEDGED BEFORE ME [rHIS DAY OF P-2 120 /' _0
PT _11% OISPERSON OWN TO ME CEI) OR WHO HAS
(%C-#)W/__ . 1110 N L
PRODUCED AS IDENTIFICATION.
> ra �
gIUNATUREOFNOIrPUBLIIC TYPF&k PRINT NOTARY
1.
COMMISSION NUMBER
(SEAL)
04b4l . —r-w-
4
SLCPDSD Revised 04/11/2011