HomeMy WebLinkAboutFILLED LAND AFFIDAVITJL\E CpG
y� ST_ LUCIE COUNTY �
IM BUILDING & ZONING 8(;AN F �^ e
_ 2000 VIRGINIA AVENUE ��/
FORT PIERCE. FL 34982.5652 y
�ORIOP 561a62.1553 St. Lucie Counfv
FILLED LANDS AFFIDAVIT
I, the undersigned, am t(h� owne/I of the following described property:
I�I lc� �T!?(9AI K� / uI.ILI._t^ial /je7A /. /,iiln
1PLIUJ
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for which I have applied to St. Lucie Countyfor a Final Development Permit. In accepting
this Final Development Permit, BP Number_09OF -dp
owner of the above described property, and In accordance with Section 7.04.01(D) tSt
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.
Property Owner Name Property Owner Si-pature Date
STATE OF FLORIOA, COUNTY OF t • r,XE
ME THIS g ^^''��
DAYOF_ )L.j ,20
n __ -
SIGNATURE OF NOTARY
NOTARY PUBLIC TITLE
IS PERSONALLY KNOWN TO ME O HO HAS PRODUCED
ENTIFICATlO _
TYPE OR PRINT NAME OF NOTARY
&00V5COMMISSION NUMBER
(SEAL)
�MICHELLE� DELROCCO�� ����'
QmnW 0
D0630178
. E>�N112010
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