HomeMy WebLinkAboutFILLED LAND AFFIDAVIT' PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 V1RG1I 1A AVENUE
FORT PIERCE, FL 34982 5652 RECEIVED
(772) 462.1553
FMLED- LAND AFFIDAVIT JAN 12 2011
PERMITTING
St. Lucie county, FIL
1. the undersigned, am the owner of the following described property,
SCANNED
BY
:ounty
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this. Final Development Permit, BP Number Lol - D 3 6 I acknowledge
that as owner of the .above described property, `and in accordance with Section
7i001(D), St. Lucie County Land Development Code, I shall be. responsible. for assuring
.A en thnt the: immediate community,"WILL-,NUT be adversely affected.
- -- _ -
I further ac"-owledge that in granting this' 'permit for thedevelopment_o , Ls 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.
I"`a ow(.a1�an.Qro/%)al�]c��tn�.Lis,dvlr
Property Owner Name (Please Print)
operty Owner Signature Date
STATE OF FLORIDA. COUNTY QF J1 • LVGtI;
.ACKNOWLEDGED BEFORE. ME THIS. I. DAYOP ,TAtjv w .20-V—.,
,BYHWKW ChµAA11Aa AND ILkT,4bA11JE WH0ISPERSONALLY KNOWNTO ME(-_-) OR WHO HAS
H M&P, lklr�k D�O7 LO
TYPE OR PRINT -NOTARY
.ot>a•P�e;•.,• T1-f—1 GABRIELLAOROZCO
oar Public - State of Florida
,�` eoP Commission # FF 212473
';;eo„o�• ;• My Comm. Expires Jun 23, 2019
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SLCPDSD:RoVisad 04111/2011