HomeMy WebLinkAboutFILLED LAND AFFIDAVITST. LUCIE COUNTY I OCT 01 2019
_ BUILDING & ZONING ST. Lucie county, Permittin
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
772-462-1553 SCANNED
BY
St. Lucie County
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
1ny f�;veR�;E� e��-se stN 3�1. FL.3,14f7ysa,1-601-60o9-000-7
(Tax M/Legal description/Address)
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.
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Property Owner Name Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF mcr �t N
ACKNOWLEDGED BEFORE
ME THIS ILO DAY OF S24L ,20 1q
BY R �P'e-tCf S WHO IS PERSONALLY KNOWN TO NIF. OR WHO HAS PRODUCED
>r-LM Pita 21214-112(,C) AS IDENTIFICATION.
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SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
NOTARY PUBLIC TITLE
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TAMABA A. GROUSE
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Notary Public •State of Florida
Commisslon # FF 995668
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My Comm. Expires Jun 12. 2020
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Bonded through National Notary Assn.
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CONINIISSION NUMBER