HomeMy WebLinkAboutFILLED LANDS AFFIDAVITRECEIVED
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• Permitting Department
St. Lucie County
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FdRT PIERCE, FL 34982-5652
(772) 462-1553
I1' ucie
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
Llsll- Sdd -vd 14 -Z)U® e/
%/ o ,A ./ Z, � r .f'c mil , o- , 1_.,1_.-7 �, G
(Parcel
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 fb' , or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
I�
`Property Owner Name (Please Print)
Y__ ��-4 � z M�L
Property Owner Signature V Date
STATE OF FLORIDA, COUNTY OF `
ACKN LEDGED BEFORE ME THIS �(J DAY OF , 20 ° CJ
W,
I1BY � ���� �)Jyl �/VQLLY KNOWN TO ME �`OR WHO HAS
XATURE
AS IDENTIFICATION.
INQSARY P LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAoyp6go SHERRI FEHLMAN
* * Commission # GG 187160
Expires March 14, 2022
FOF FI�P Bonded Tbv Bwget Notary services
SLCPDSI? Revised 08/24/2010