HomeMy WebLinkAboutFILLED LAND AFFIDAVIT121
RECEIVED JUN S'�zUCIE COUNTY
BUILDING & ZONING
2300 VIRGH41A AVENUE SCANNED
FORT PIERCE, FL.34982-5652 BY
772462-1553 St. Lucie County
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the followhng described property:
I tot t,ofl o13S—000-`\/G�-t4wood. 11<k- w..�8/f-dl.(CS
(Tax 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 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 Property Owner Signature Date
STATEOFFLARIDA,COUNTYOF
ACKNOWLEDGED BEFORE METIUS T-r" DAY OF a 9IR-1 L . 20-LI
BY Lo 22 A I NF= PO S T WHO IS P17LSONALLY KNOWN TO ME OR WHO HAS PRODUCED
I/,21 VL-� L I GEN SE AS IDENTIRrAnON.
C'"m Sn its , FZM A+IFF
TARY TYPE OR PRINT NAME OF NOTARY
1W-Ya SE
J.FRYAUFF
o 'TICII ARY PUBLIC
NOTARY PUBLIC TITLE i' COMMISSION NUMBER -STATE OF FLORIDA
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