HomeMy WebLinkAboutFilled Land Affidavit R E C'E 2317
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
sales , Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 -aI V D
(772)462-1553
MAR 0 6 2017
FILLED LAND AFFIDAVIT PERIIAJTTII,,*r
1,the undersigned, am the owner of the following described property,
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(Parcel ld#/Legal description/Addre0)
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(Please Print)
Qjagj 1-7
Property O Signature Date
STATE OF FLORIDA,COUNTY OF t
BEFORE ME THIS DAY OF 120 I -7
BY -e, i*'V—r -WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED S-O�C-r L—Z C-e- e- AS IDENTIFICATION.
col I C t-k N C'-S4 e-
STUfFATURE OF 10TARY PUBLIC TYPE OR PRINT NOTARY
(71- -1 _COMMISSION NUMBER
(SEAL)
COLLEEN SUE HAYES
C01111-55
'fon N FF 209728
MY Commission Exp,ies
SLCPD S D Revised.I Murch 15. 2019