HomeMy WebLinkAboutFILLED LAND AFFIDAVITST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
2300 VIRGINIA AVENUE
FORT PIERCE, FL 349112-5652
561-462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of thejollowing described property,
332r1-&'W-ooco-600 3 c.r.t..6S1j>Es �,t *r. . 35 3.q
SCANNED
By
St. Luce County
(tax IDAegal descrlpGoNaddress)
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.
r
F&16 PCr S VA -IL -
Property Owner Prop Ow er Date
(Print) (Signature)
STATE OF FLORIDA, COUNTY OF ST LIac1 P Q
SWORN TO
AND SUBSCRIBED BEFORE ME THIS / � DAY OF
(
BY _ 2""'vw 7 - V4;,P— 6F99O IS PERSONALLY
AS IDENTIFICATION.
L—YAJ nl E7 h4 a P /L0-
TORE OF NOTARY TYPE OR PRINT NAME OF NOTARY N Y
NOTARY PUBLIC TITLE COMMISSION NUMBER
WHO HAS PRODUCED
(seal)
LYNNE MOORE
Notary Public, State of Florida
My comm. exp. Sept. 23. 2003
Comm. No. CC873856
SLCCDV FORM NO.: 011-00