HomeMy WebLinkAboutFILLED LANDS AFFIDAVIT=Y'
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE SCANNE11
FORT PIERCE, FL 34982-5652 BY
(772) 462-1553 cooty
St. Lucie
FILLED LANDS AFFIDAVIT
1, the undersigned, am the owner of the following described property,
(Parcel Id#/Legat 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.
Pro
7-�2Q-13
o Owner Signa a Date
STATE OF FLORIDA. COUNTY OF ��/ •�< <„
ACIO40WLEDCMF�.Z DAY OF
BY /���KYrrJ��(LLJJ lS� WHO I FASONALLY Iml TO OR WHORAS
PRODUCED / �,per AS IDENTIFICATION.
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SIGNATURE OO/F1NOTARY PUB TYPE OR PRINT NOTARY
COMhRSSION NUMBER
IpCl1RELBEfRiIN
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it Commission EE 11r41
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SLCPDSD Rwiwd 08242010
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
EPRCI
D
FILLED LAND AFFIDAVIT 8
mittt,o 1
I,the undersigned, am the owner of the following described property,
m S. Oceo AD r0D . ; ,wse,�, ZpAzl. ire 3V4-r2 ® 0d72 33)—oo&z —
Rrce11d#/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.
® Re6pr-1- N. �Uszaz
Pro"Owner N (Pe Print)
Property Owner Signature D
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE MEE�THIS DAY OF A " l �/. 20 / 9
fl — BY 11C1 /T Y� . I!: /IS?4 wH0 IS PERSONALLY KNOWN TONE II OR WHO HAS
PRODUCED
AS IDENTIFICATION.
�" P'XI:,) Ce. Cba 1
SIHOFTARYPUB I TYPE OR PRINT NOTARY
GCOMMISSION NUMBER
SLCPDSD Revised 04/112011
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EXPIRES: March 6 2022
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