HomeMy WebLinkAboutFILLED LANDS AFFIDAVIT�J �E COGy ST. LUCIE COUNTY
BUILDING & ZONING
23M VIRGINIA AVENUE
• ' tl FORT PIERCE, FL 349825652
��ORIOP '62"15M
FILLED LANDS AFFIDAVIT SCANNED BY
St Lucie. County
I, the) undersigned, am the owner of the following described property:
(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
STATEIOF FLORIDA, COUNTY OF &A. L.L44,
ACKNOWLEDGED BEFORE ME THIS
I �2 DAY OF VL��L ,20i77
BY LC.SK-r L • r,1,—[-,- WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
L AS IDENTIFICATION.
IGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE COMMISSION NUMBER (SEAL)
u,n.
..............
P�o���
�iV
SCOTTA. ODENTNAL
Notary Public • Slale
of Florida
•, My Commission ExpiresAp,30, 201
'�-'
Commission p DD 637660
Bonded Thmueb Nannn.I u.,__.. _ _