HomeMy WebLinkAboutFilled Land Affidavit RECEIV rD AUG 04 2017
s
p PLANNING &DEVELOPMENT SERVICES DEPARTMENT
� Building&Code Regulations Division .
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the ownerofth following described propert
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(Parcel d#/Legal description/Address)-
for which I have applied to St. Lucie County for a Final Develo ment Permit. In
accepting this Final Development Permit, BP Number 11dd_O1; 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 erty Owner Name(Please rint)
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J
roperty Owner Signature Date
STATE OF FLORIDA,COUNTY OF L-c
ACKNOWLEDGED BEFORE ME THIS !A DAY OF Q 1S 120
BYy V�A�C�d S�(l���o,�a WHO IS PERSONALLY KNOWN TO MEQ OR WHO HAS
PRODUCED L' 1�1""' AS IDENTIFICATION.
SIGNATURE OF NOTAR PUBLIC TYPE OR PRINT NOTARY
dS OMMISSION NUMBER
DEANN �GIVENS-----�..
MY COUPdISSION#GG 022023
EXPIRES:December 16,2020
''•;q ;°�' Bonded Thru Nob3ry public underweis s t
SLCPDSD Revised 04/11/2011