HomeMy WebLinkAboutFILLED LANDS AFFIDAVITSCANNED
BY
�ORI�p•
ST. LUCIE COUNTY
BUILDING & ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
561-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
for which I have applied to St. Lucie County for a Final Development Permit. `fn,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
STATE OF FLORIDA, COUNTY OF S7 L,I,(elr:z
Property Own Lure Date
D BEFORE ME THIS I 'Vt DAY OF 2
BY ya—jx( WHO IS PERSONALLY KNOWN TO ME)OR WHO HAS PRODUCED
SIGNATURE OF NOTARY
NOTARY PUBLIC TITLE
IDENTIFICATION.
J.i1JAJkr J-CD 194�
TYPE OR PRINT NAME OF NOTARY
COMMISSION NUMBER
LYNNE MOORE
Comm# OD0232868
Expires 9/23/2007
Bonded thru (800)432-4254
Florida Notary Assn., Inc.
(SEAL)