HomeMy WebLinkAboutFILLED LAND AFFIDAVITSCANNED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT BY
Building & Code Regulations Division St. Lude'C0wbi
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 VED
FILLED LAND AFFIDAVIT
LA
"0':qy, Permitting
I, the undersigned, am the owner of the following described property,
Id#/Legal
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.
�& liaoilaw Ahms
Property Owner Name ( ease Print)
' r--_ Vfte!��'O`Property�0 nerSigna[ure
STATE OF FLORmA, COUNTY OFJQI/IE bACIC
ACKNOWLEDGED BEFORE ME THIIS
BY ItJ11fiQM r. njo.1 4
SIGNATURE OF NOTARY PUBLIC
7I j1J7&aN COMMISSION NUMBER
SLCPDSD Reviud 04/11/2011
D 20�
WHO IS PERSONALLY KNOWN TO M `(�'�� OR WHO HAS
� DENTIFICATION.
PATRI[(s1�,aNN GRIFFIN
MY COMMIIS`"SSII N # GG137624
i
'a„•,;,,.•- EXPIRES September 26, 2021
,
PLANNING & DEVELOPMENT SERVICES iplAF G� T
Building & Code Regulations Division �+/�/tn'p�
FORT PIERC4349V 82-5652 t7t�ttNNED
("2)462-1553 BY
StLudeCono
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner of the following described property,
ld#/Legal
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number ik�, 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 forth,
adequate drainage off my property which will not adversely affect the immediate
community.
�erNamPropease Print
�[op Owner Signature
STATE OF FLORIDA. COUNTY OF&III �+F�._
ACKI1NOWLEDGED EFOREMETHIS J DAY OF 20 'P _
BY161� _ km wHOISPERSON KNOWNTOME( OR WHO HAS