HomeMy WebLinkAbout24030475 FILLED LANDS AFFIDAVITST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
561-462-1553
FILLED LANDS AFFIDAVIT
the undersigned, am the
6006 -00
r of the following described
2z12 r rd0-Ovo7- 000,
�zz�a-� oo- �vvs'—uo���✓
(tax ID/legal description/address)
r which I have applied to St. Lucie County for a Final Development Permit. In accepting
is Final Development Permit, BP Number AaDq 69% . I acknowledge that as
vner of the above described property, and in accordance with Section 7.04.01(D), St.
icie County Land Development Code, I shall be responsible for assuring adequate
'ainage so that the immediate community WILL NOT be adversely affected. I further
;knowledge that in granting this permit for the development of this property, St. Lucie
aunty is neither obliged nor liable to provide for, or maintain in any form, adequate
ainage off my property which will not adversely affect the immediate community.
'r=NDA 61kf 3sEn
Owner
Property Owner Date
(Signature)
IATE OF FLORIDA, COUNTY OF S-4-1 L'
TO AND SUBSCRIBED BEFORE /ME THIS DAY OF N J , 20 O Z-
A �cx (Z,,Iv5 & c WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
IDENTIFICATION.
-7GN t XA-
TYPE OR PRINT NAME OF NOTARY
TITLE - oC 4?�?0 343 COMMISSION NUMBER
� h
♦ �i
•�� # Lira
=a ERP/nea pot CC 870323
•F.� Atlentto°°ded, A2003
OandtnB Co., Lo:
SLCCDV FORM NO.: 011-00