HomeMy WebLinkAboutFILLED LAND AFFIDAVITI
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�yED ST. LUCIE COUNTY
i. U aoUnW BUILDING & ZONING
2300 VIRGINIA AVENUE
FORT PIERCE. FL 349825652
. 462-15M
FILLED LANDS AFFIDAVIT
undersigned, am the owner of the following described property:
` oS - 4 2-1 - 0001- 000- 2
(Tax ID/Legal descripffon/Address)
for vhich I have applied to St. Lucie County for a Final Development Permit. In accepting
this Final Development Permit, BP Number , I acknowledge that as
ow ;er 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
drat age so that the immediate community WILL NOT be adversely affected. I further
ack iowledge that in granting this permit for the development of this property, St. Lucie
COL my -is neither obliged nor liable to provide for, or maintain in any form, adequate
draj age off my property which will not adversely affect the immediate community.
c
y Owner Name Property Owner Signatur Date
STAI EE OF FLORIDA. COUNTY OF S T. I--u-C.I I
ACK OWLEDGED BEFORE ME THIS 31 DAY OF M14 Y . 20_p,�
BY L 4 IC 0y Dg WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
I
AS IDENTIFICATION.
OF NOTARY TYPE OR PRINT NAME OF NOTARY
PUBLIC TITLE COMMISSION NUMBER (SEAL)
�r R� Notary Public State of Florida
Jennifer Pottorif
My commission DD445478
Expires 0911012009