HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
Lay
St. Lude Could
ST. LUCIE
ST. LUCIE COUNTY
BUILDIN • D
2300 VIR INIA AVENUE
FORT PIER E,13Tj - 6f2018
772 462-15
ST. Lucie County, Permitting
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described propertyN(_9
3427-111-0002-000/5
(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 J , - "C / E
ACKNOWLEDGED BEFOREMETHIS DAY OF -:jr u 4-y , 20 to
BY%f}TT1•I FLJ L YtC W YNrJ6 WHO IS PERSONALLY KNOWN TOME OR WHO HAS PRODUCED
SIGNATURE IOFTARY
NOTARY PUBLIC TITLE
IDENTIFICATION.
'Da Y, J+t4P4
TYPE OR PRINT NAME OF NOTARY
(SEAL)
pie? ?tisl;•; DOROTHYANN BASKIN
MY COMMISSION # GG 030145
EXPIRES: October 2, 2020
Bonded Thru Notary Public Underwriters