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HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT Building & Code Regulations Division 2300 VIRGMAAVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 FILLED LAND AFFIDAVIT SCANNED BY St. Lucie County I, the undersigned, am the owner of the following described property, 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. All Ij Ih'altit w f}dams. Property Owner Na a (Please Print) n —PPoperty wrterSignature t �I7 Dale STATE OF FLORIDA. COUNTY OF_�/)QT 1 S ACKNOWLEDGED BEFORE ME THIS_�DAY OFO�-ee- _20_Z? . BY�) 111AM qd l"S WHO IS PERSONALLY KNOWN TO ME C/ 1 OR WHO HAS PRODUCED Ap //{ SIGNATURE OF NOTARY PUBLIC e I3 ✓ld COMMISSION NUMBER SLCPDSD Revised 04/112011 IDENTIFICATION. °•` P�'I4FIl;lA ANN GRIFFIN MY COMMISSION # GG737624 Ei� .�„91',.`' EXPIRES September 28, 2021 PLANNING & DEVELOPMENT SERVICES DEPARTMENT Building & Code Regulations Division 2300 VIRGIMAAVENUE FORT PIERCE, FL 34982-5652 (772) 462-1553 FILLED LAND AFFIDAVIT SCANNED St: Lira �ounp(, I, the undersigned, am the owner of the following described property, 39DL-U0$- o i9- 000-1 (Parcel Id#/Legal description/Address) for which I have applied to St. Lucie County for la Final Development Permit. In accepting this Final Development Permit, BP Number %[' 06 51 , 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 �iVILL 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. , Bryan �dGrnf Property Owner Name (Please Print) pp 77 Property igature I I n I c O Dale i STATE OF FLORIDA, COUNTY OF SIA I 1 1 'F I W ( I _r ACKNOWLEDGED BEFORE ME THIS DAY OF W C4 ry 20 (�a 1� BY Bryarl 6aam r WHO IS PERSONALLY"'1OWN TO ME WHO HAS PRODUCED ((� ` _ { AS IDENTIFICATION. \\lfNf��C` D ,11� ��MMjaN SIG�NAT�U�RE OF OT PUBLIC TYPE OR PRINT N ARY ffft g COMMISSION NUMBER SLCPDSD Revised 04/11/2011 (SEAL) "'u+�"•., - HICHAILD DOOGLAS JOHNSON NolaryPublic-stale olFbrida Canmission#GO C84821 MYComm. Expires Mar20,202f orn�•' . RrAe70Yay�NacurdwmayAwi.