HomeMy WebLinkAboutFILLED LAND AFFIDAVITST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-6652
561-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
SEE ATTACHED
(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.
r "A
Planar, Inc — Leo Henriques
Property Owner
(Print)
STATE OF FLORIDA, COUNTY OF Indina River
SWORN TO AND SUBSCRIBED BEFORE ME THIS 16th DAY OF July 20Q(L,
By Leo Henriquez WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
himself AS IDENTIFICATION.
Kendahl R. Boyd (seal)
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY ,4yPY,,, Kendahl R. Boyd
q MY COMMISSION # CC835628 EXPIRES
11, 03
NOTARY PUBLIC TITLE CC835628 COMMISSION NUMBER` BONDEDTHRUTROYFNS%r `O�' May TROY
FAN NINS
URANCE INC
SLCCDV FORM NO.: 011-00