HomeMy WebLinkAboutFILLED LANDS AFFIDAVITST: LUCIE1 COUNTY
BUILDING & ZONING
mw V1RGIMA AVENUE
FORT PIERCE FL 34982•SOU
561J62.1SS3
FILLED LANDS AFFIDAVIT _ __ _SCANNED
BY
St. Lucie County
I. the undersigned, am the owner of the following described property:
66S= ,oho • 703 - z.677-- 737-�
E,e- c1-44—CA-..
(Tax ID&egal descip6ordAddress)
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
le to provide f
drainage off my property which will not adversely affect heliequate
immediate communitntain in any form, y.
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roperty Owner Signature Date
Property Owner Name
bIa n
STATE OF FLORIDA. COUNTY OF "
ACKNOWLEDGED BEFORE ME THIS DAY OF�JV�
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
BY
tUersonally Known AS IDENTIFICATION.
. l_u ire_ 1_entiflcatinn
Type of Identification
TYPE OR PRINT NAME OF NOTARY
SIGNATURE OF NOTARY
NOTARY Pr 1a dQ TITLE
yr + Sandra S Fausea
My Commissbn C0939926
3„'w5f Expires June 9, 2o04
COMMISSION NUMBER
11