HomeMy WebLinkAbout0504-0180 FILLED LAND AFFIDAVIT�E co SCANNE0
J Gy BY ; ST. LUCIE COUNTY
StLudeCdof1BUILDING &ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34962-5652
��RiQP 561-462-1553
FILLED LANDS AFFIDAVIT
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I, the undersigned, am the owner of the following described property:
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(Tax ID/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In accepting
this Final Development Permit, BP, Number 050 c- OMO , I acknowledge that as
owner of the above described property, and in accordance with Section 7.04.01(D), St.
Lucie County Land Development ,Code, I shall be responsible for assuring adequate
drainage so that the immediate co'Immunity WILL NOT be adversely affected. I further
acknowledge that in granting this permit for the development of this property, St. Lucie
County is neither obliged nor liable to provide for, or maintain, in any form, adequate
drainage off my property which will snot adversely affect the immediate community.
Vrc- A c. r I c-,(-r i-i a:
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF . �U1.c-
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ACKNOWLEDGED BEFOIRE ME -THIS @IS O I DAY OF - \" \&KCl 20fl r%
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BY Q�j hi S
\IDSPe r r WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
AS IDENTIFICATION.
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SIGNATURE OF NOTARY
NOTARY PUBLIC TITLE
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4DD 285684
TYPE OR PRINT NAME OF NOTARY
(SEAL)
COMMISSION NUMBER