HomeMy WebLinkAboutFILLED LAND AFFIDAVITi
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT 4'
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I, the undersigned, am the owner of the following described property,
33ag-10)-0era-00d-5AM/E tkorz AtmSF /v ,Lo%ice
(Parcel Id#/Legal descripfaon/Address)
3S Cfhcin�r-r�T
PDei Si .Lucr�.�-3�14��0
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.
GQ �'VL�j �iCti
Property Owner Name 031e a Print)
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Property Omg& Signature DWI
STATE OF FLORIDA, COUNTY OF c�`--LLI.l
ACKNOWLEDGED BEFORE ME THIS- �t DAY OF L�yY1 � , 20 IIS,
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BY �l V (7(3Pi ".V A\Q �14 WHO IS PERSONALLY KNOWN TO ME (a OR WHO HAS
PRODUCED �o n�PJCs r\GL1
SIGNATURE OF NOTARY PUBLIC
oQ \?)aa!EjCOMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
TYPE OR PRINT NOTARY d
CARRIE-ELLEN IWANKO
Public - State of Florida
Co mission # GG 013829
My Comm. Expires Jul 20, 2020
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