HomeMy WebLinkAboutFILLED LAND AFFIDAVITST. LUCIE COUNTY
BUILI)ING & ZONING
2300 VIRGINIA AVENUE
FORT PIERCE, FL.34982-5652
772462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
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(Tax ID/Lejal descdption/Address)
SCANNED
BY
St. Lucie County
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
nnr 1 inhle to Drovi_de for —or maintain in any form, adequate drainage off my property which
will not adversely affect the immediate
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roperty Owner Name Property Owner Signature Date
STATE OF FLORIDA. COUNTY OF
ACKNOWLEDGED BEFORE METHIS DAYOF ,20/
Y`�(�
By A e \yk L n WHO is PERSONALLY KNOWN TOME OR WHO HAS PRODUCED
r�� AS IDENTIFICATION.
NOTARYPUBLIC TITLE
TYPE OR PRINT NAME OF NOTARY
COMMISSION NUMBER
,•�+'::^4a•. JOANNEWILLS
Commission!! FF 188304
a4 e;J Expires February 20, 2019
8.4MT T,, Fsn I.. SW7019
(SEAL)
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