HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPART
Building &Code Regulations Division RECEIVED
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 JUN 06
(772) 462-1553 2019
5T, Lucie County, permitt
FILLED LAND AFFIDAVIT
SCANNED
St Luc a C
I, the undersigned, am the owner of the following described property, ounty
3oa. -o21/ �2 P,' , Fl 3Y9�
(Parcel Id#/Legal descriptioniAddress)
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.
9ti4 ��✓�e2�Krszs,. e=
P erty Owner Name (Please, Print)
&&.& Pr•--s.
Property Owner Signature
STATE OF FLORIDA, COUNTY OF 11AX-1,Z41
'-k(\'3i«
Date
ACKNOWLEDGED BEFORE ME THIS io DAY OF M"q- , 20 l / ,
BY L;WOA 6zog/," WHO IS PERSONALLY KNOWN TOME OR WHO HAS
PRODUCED f AS IDENTIFICATION.
SL�iu/ .�9D
SIGNATURE O O,VARY PUBLIC TYPE OR PRINT NOTARY
GG / 9y 3 7Y COMMIssIoN NUMBER
(SEAL)
SLCPDSD Revised 04/112011
=s►"o °6sL� eRao
State of Florida
My Commission Expires 04/06/2022
°`�` Commission No. GG 199378