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
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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)
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HICHAILD DOOGLAS JOHNSON
NolaryPublic-stale olFbrida
Canmission#GO C84821
MYComm. Expires Mar20,202f
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