HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
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2300 VIRGINIA AVENUE
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,
402 -I 15
(Parcelld#/Legal
0101- 000- 7-
for which I have applied to St. Lucie County for, a Final Development Permit. In
accepting this Final Development Permit, BP Number 191 1 - 0 0 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 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.
Bryan naams
Property Owner Name (Please Print)
� I
Property caner ,gnature i 1 I g 12
Dale
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STATE OF FLORIDA, COUNTY OFs, lrl1 1 ((l-f "dry `I
ACKNOWLEDGED BEFORE
/M�iE THIS O DAYOF L/U Yi�V 20__Z 0
WHO IS PERSONALLY KNOWN TO ME C)(j OR WHO HAS
PRODUCED I
D,, 11 1 ` AS IDENTIFICATION.
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SIGNATUREOFIr4ki[AIVPUBLIC TYPEOR PRINT NUTARY
ffkmuj—LcOMMISSION NUMBER
(SEAL)
,. •' �r�,�';.;, RINAROOMIGLASJOENSON
Notary public - Sateof Arrda
SLCPDSD Revised 04/112011 : _ CommissrongG13084821
" i; My Comm. Expires Mar 20.2021
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulation's Division
2300 VIRGINLA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDASCANNEDVIT BY
St. Lucie County
I, the undersigned, am the owner of the following described,property,
(Parcel
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.
Property Owner Name (PI ase Print)
Property 'ignature Date
STATE OF FLORIDA, COUNTY OFS_hl I){�/jye l ACKNOWLEDGED BEFORE ME THIS:913 DAY OF 20 L/p
BY LU i x&" aruan /3d 10 s IS PERSONALLY KNOWN T ) OR WHO HAS
PRODUCED AS IDENTIFICATION.
s a, JQ0A r' 0
/I91oN}AlTUR/E OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
"'°"''• (SWRICIA ANN GRIFFIN
MY COMMISSION M GG137624
•�o4o..t?;l` EXPIRES September 26, 2021
SLCPDSD Revised 04/11/2011