HomeMy WebLinkAbout0704-0263- FILLED LAND AFFIDAVIT`i
COUNTY.
F L O Ra -1- D _ A.
ST. LUCIE COUNTY
BUILDING &. ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
772-462-1553 '
, FILLED LANDS AFFIDAVIT
I, the undersigned, am the owne of the following d c bed propert . �
i�7`lo C`'�eec� O�ense� L 3�1 5`"l $b�
(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 , 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 community 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 not adversely affect the immediate community.
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA, COUNTY, OF nFNL \\4
ACKNOWLEDGED BEFORE ME THIS DAY OF 200�
BY l�y ���Q��\t WHO IS PERSONALLY KNOWN TOME OR WHO HAS PRODUCED
AS IDENTIFICATION.
SIGNATURE OF NOTARY
TYPE OR PRINT NAME OF NOTARY
(SEAL) '
NOTARY PUBLIC TITLE COMMISSION NUMBER
STELLA M. HUNTER
MY COMMISSION # DD 630775
q EXPIRES: January 23, 2011
t%0niod?hruNotvr Public Undorkhem