HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
J ' Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
ED 772)462-1553
ECEIV
A F R 3 0 MLED LAND AFFIDAVIT
[ST. Lucie countyj �pP' lttlnQ
1, the undersigned, am the owner of the following described property,
1301-601-0045-000-9
(Parcel Id#/Lepl 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 WELL 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.
Joseph Miller
Property Owner Name(Please Print)
rdy er Si e 1ate
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS `J DAY OF _,20�
BY b Q b WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
��11
PRODUCED A <S)'Y1 V GC-T b Q✓-A_ AS IDENTIFICATION.
kel
S GNATURE OF NOT# Y PUBLIC TYPE OR PRINT NOTARY
6Z-NPg4-COMMISSION NUMBER
s ALEXANDRA PEARSAUL
s Notary Public-State of Florida
r Commission;GG 148547
My Comm.Expires Oct 4,2021
SLCPDSD Revised 04/11/2011