HomeMy WebLinkAboutFILLED LAND AFFIDAVITISOG-0s,�-i
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE SCANNED
FORT PIERCE, FL 34982-5652 BY
(772) 462-1553 St. LUde Count%,
FILLED LAND AFFIDAVIT RECEIVlm juN 2 6 2m
I, the undersigned, am the owner of the following described property,
(Parcel
Ffflwra—E
-'4 kvp
8LYD
—21126)
for which I have applied to St. Lucie County for a Final Development Permit. Jn
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 ffirther 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.
y6k"'.. A"'06'g VAWt cot -,Ay
Property O%vner Narn6 (Please Print)
Property Omer Signature Date
STATE OF FLORIDA, COUNTY OF WC:1115
ACKNOWLEDGED BEFORE ME THIS -2—G DAY OF -� Ot35' '20 kl��>
BY rPeI�?- rD. CkQi-�T WHO IS PERSONALLY KNOWN TO ME CY—) OR WHO HAS
PRODUCED AS IDENTIFICATION.
NUMBER
1-1"OTARY
(SEAL)
SLCPDSD Raised 0411 InOI I SHIRLEY A. SAUNIER
Notary Public - State of Fit rida
MY COmm. Expires J,n 31,02017
B n=ission # EE 861169
ough National Notary Assn.