HomeMy WebLinkAboutFILLED LAND AFFIDAVITST. LUCIE COUNTY
BUILDING & Z NINUG CEIVED
2300 VIRGINIA AVENUE
o FORT PIERCE, FL 34?82-565SEP 2 6 201163
772-462-1553
ST. Lucie County, Permitting
D LAND S AFFIDAVIT ����
FILLS �, ���;
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undersigned, am the owner of the following described property\� �0��-e���
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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 CST • LNJ kA A�
ACKNOWLEDGED BEFORE ME THIS WY
`L r - �
41DAY OF e/+r , 20
BY I�}' ri -W CyL.F Wig/��WH
HOISPERSONALLYKNOWNTOMEORWHOASPRODUCED
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SIGNATURE OF NO ARY
NOTARY PUBLIC TITLE
IDENTIFICATION.
�o ►2 o i I-1 5/ � r� U ��c ,�
TYPE OR PRINT NAME OF NOTARY
(SEAL)
CQ�iIfSION YANNBASKIN
MY COMMISSION # GG 030145
EXPIRES; October 2. 2020
Bonded Thru Notary Public Underwriters