HomeMy WebLinkAboutFILLED LAND AFFIDAVIT�� i g► a- o a62.
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
0 Building & Code Regulations Division
2300 VIRGINIA AVENUE
® FORT PIERCE, FL 34982-5652
(772)462-1553
RECENED SCANNED
FILLED LAND AFFIDAVIT BY
DEC 12 R018 St. Lucie County
Permlttin6 Department
St. Lucie CUUnty'
I, the undersigned, am the owner of the following described property,
(Parcel IM/Legal description/Address) 57a � 1'n� (,(f ae 1 FDY4 Verez ,, s�
for which I have applied to St. Lucie County for a Final Development Permit. In3
accepting this Final Development Permit, BP Number acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie CountyLand 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.
ZN9in�
Property Owner Name (Please Print)
►r2p���8
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF a LUdit,
ACKNOWLEDGED BEFORE ETHIS � DAYOjJA#'(N%&'r_ .201V
BY�Q arrUN 1 &x% wno IS PERSONALLY KNOWN TO ME ZbOR WHO HAS
PRODUCED
IDENTIFICATION.
tca>ricQQc. %riYlb�iYt�. l�i[.lttlLe % a-�l'u/
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
J55tolgCONWSSIONNUNIBER
(SEAL)
KRISTINE MICHELLE TAYLOR
.oirA Wi'•..
State of Florida -Notary Public
'- Commission GG 156618
SLCPDSD Revised 04/112011 =y®
,�� My Commission Expires
October 29, 2021