HomeMy WebLinkAboutFILLED LAND AFFIDAVITon COUNTY
F L O R I D A
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION ww��
2300 VIRGINIA AVENUE S(;P' NED
FORT PIERCE, FL 34982-5652 BY
(772)462-1553
St. Lucie County
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel 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 Mos-p3('C) 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
Property Owner Name (Please Pr•
Property Owne ignature Date
STATE OF FLORIDA, COUNTY OF O l nr i : n
ACKNOWLEDGED BEFORE ME THIS l{ 1` DAY OF C J U I u . 20 1 I
BY (`g n A •i Six. er' WHO IS PERSONALLY KNOWN TO ME,� OR WHO HAS
PRODUCED
1A1MA
SIGNATURE OF NOTARY PUBLIC
IiD 4 A9-N3 COMMISSION NUMBER
SLCPDSD Revised 08/242010
AS IDENTIFICATION.
TYPE OR NOTARY
(SEAL)
\\\11 W-O.Y%
`r1 BRANDYWATLEY
•Notary PUGIic •State of m: Expires May ]Florida,,9, 2014
''•pFi1 Commission # DD 989743
ST. LUCIE COUNTY
BUILDING & ZONING
2300VIRGM AVENUE
FORT PIERCE. FL 349925652
561 462-IS53
FILLED LANDS AFFIDAVIT
S'P �4c eyN�C}
e cou,
I, the undersigned, am the owner of the following described property: h`
Ikrs �rx�k 72c- J442.2. - Zia- oolo- boo-8
(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 scc o- ns-- 03(n . 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.
lj
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA. COUNTY OF e . OeZAt ,
ACKNOWLEDGED BEFORE ME THIS p5 �J `'DAY OF ?)n9W 20Q1,
BY S.Gj QJO11J'rQQ� HOI PERSONALLY KNOWN TO E OR WHO HAS PRODUCED
AS IDENTIFICATION.
SIGNATURE OF NOTARY
NOTARYPUBLIC TITLE
90nc1t 0. A90re
TYPE OR PRINT NAME OF NOTARY
(SEAL) _
,,, 6u1sCOMMISSION NUMBER �•r Many r..•.,,,,a
Jj" 'MY Cemmiaaien JVW4915
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