HomeMy WebLinkAboutFilled Land Affidavit Ij
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Ivision
• 2300 VIRGINIA AVENUE,
FORT PIERCE,FL 34982-5652
(772)462-1553 j
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FILLED LAND AFFIDAVIT
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I,the undersigned, am the owner of the following desclibed property,
C900 �0oA& ' �a^l �
(Parcel I&ILegal description/Address)
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for which I have applied to St. Lucie County for Final Development Permit. In
accepting this Final Development Permit, BP Numb� , 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 noti adversely affect the immediate
community.
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Pr Owner ame(P s Print
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Owner 4gnatureU Date
STATE OF FLORIDA,COUNTY OF 5T• Z-6Gi`✓
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ACKNOWLEDGED BEFORE ME THIS 7"� DAY OF �,20
BY WHO IS PERSONALLY KNOWN TO ME L!/ OR WHO HAS
PRODUCED AS IDENTIFICATION.
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E' SIGNA URE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
— r a 3 18149COMMISSION NUMBER
7 (SEAL:
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SLCPDSD Revised 04/11/2011 `" CYNTIBAKER
MY CONMSSION#FF231810
EXPIRES:June 29,2019
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