HomeMy WebLinkAboutFilled Land Affidavit '4
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
1 u .�,> RECEI\/ED
Building&Code Regulations Division
_ 2300 VIRGINIA AVFNUE
FORT PIERCE,FL 34982-5652 APR 0 2 2010
(772)462-1553
Permitting Department
St. Lucie County
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
2261e. lei 0- 6009-000- 2 Z
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Develo Tent 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.
�J , 0/1',
erty Owner Name e e Pri tj
Z'
Pro&lyOwner Signature Date
STATE OF FLORIDA,COUNTY
ACKNOWLEDGED BEFORE ME THIS DAY OF 20—ti,
BY WHO IS PERSONALLY KNOWN TO ME( y )OR WHO HAS
PRODUCED AS IDENTIFICATION.
C � 1
SIGNATURE OF NOTARY P IC T E O T NOT Y
S COMMISSION NUMBER
(SEAL)
SHIRLEY K.BEMENDERFER
;.:Commission#FF 989655
SLCPDSD Revised 04/11/2011 ;r.e ��:•'Exoire8 May 8,202o
6andoC i'1111 Troy fain InS11rance 800.388-7019