HomeMy WebLinkAboutFilled Land Affidavit ST. LUCIE COUNTY
BUILDING & ZONING APR 10 2017
2300 VIRGINIA AVENUE PER.'ArF ING
FORT PIERCE,FL.34982-5652 St. Lucie County, FL
o o 772462-1553
F`IILED-LAS
I,the undersigned, am the owner of the following described property:
(Talc 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 weer Name Prop caner Signature Date
STATE OF FLORIDA,COUNTY OF
ACIWOWLEDGED BEFORE ME TTIIS A _DAY OF
BY , , IJ WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
ELI AS IDENTIFICATION.
AA
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
.�— (SEAL)
NOTARY PUBLIC TITLE COMMiSSION NUMBER
O pAY Ug'
KAi2EN S. (V1ELSEP! --�
Commission N FF 115 :37
-N
My Commission ExPi�F's
,fu.1e 12, 201 8