HomeMy WebLinkAboutFILLED LAND AFFIDAVITA
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT SCANNED
BY
St. Lucie Countv
I, the undersigned, am the owner of the following described property,
572�o rCnvimnm4* Dr►VC, 1�4- Pi-,(M I FL 3 V71Z
33ol-561 -oo03 -000lz rp4t,ws Cf 1?tol DA 2iyy kpI40YULCPS `%S-7) Lof 23
(Parcel Id#/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 I311.0obZ , 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 iliable to provide for orrmaintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
CeMC_ J' Ca"W ucr/Oti) 1•//}j Ftl ll�C.S �� OI:11�i� i��' �
Pro erly Owner Name (Please Print)
Z q4 1 b
P p Dwner Sign e nn Date
�^ ,ra6 rt6sroavr
STATE OF FLORIDA, COUNTY OF P4Irn vefi-C.-
ACKNOWLEDGED BB� EypFORE ME THIS �� DAY OF Y'e. b %rl Y'�-, //, 20 l b ,
BY AATLIMA4 tC WHO IS PERSONALLY KNOWN TO ME(v)OR WHO HAS
PRODUCED - AS IDENTIFICATION.
SIGNATURE
SURE � PUBLIC/-
f f �U-64%OMMISSION NUMBER '
SLCPDSD Revised 04/11/2011
• 'r''n"" CYNTHIA HELWIG
°• ; ? NoE3S�y lic -Stale of Florida
2?•% -; My Comm. Expires Oct 20. Mill
e'
. �`°r Commission # FF 136664