HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division RECEIVED
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 AUG 0 8 2019
ST. Lucie County, Pent,
FILLED LAND AFFIDAVIT
SCANNED
1, the undersigned, am the owner of the following described property, BY
1% Ludecolint%
2do7.-60<-00q4-NV-61 Sb+ F, mtorJAq 12,6AV f3ar
(Parcel ld#/Legal description/Address)
far which I have applied to St.. Lucie County- for a Final Development, Permit. In,
accepting this Final Development Permit, BP�Nutnber I acknowledge
that as owner of the above described' property, and in accordance witli 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 z.,property w1mch wig izat -adversely affect the munediatc
�'COMMunity-
M MtA -rr C,&,LA
A�
Property Owner Name (Please Print)
Propierly Ownd�§ignahtrer
Da(, —
STATE OF FLORIDA, COUNTY OF
ACKNOWL DBEF05ETFHS
DAY OF 20A�
I LIAHW-'�
WHO IS PERSONALLY KNOWN TO MFO
j OR WHO HAS
'PRODUCED T) I
AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
=KAREN S. NIELSEN
Sta of I Pj
te F N 0 1 a ry u b I'c
9 # G G 20748 4
Comm's a'
eo_ my Com a 'o n E x P, re a
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2 L22 =2
4,,SStale of Florida -Notary Public (SEAL)
Commission # GG 207484
my Commission Expires
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114
June
12. 2022
SLCPDSD Rcvi�d 04111/2011