HomeMy WebLinkAboutFilled Land Affidavit ammillimmillik1
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
•SaglIYCou
�y Building&Code Regulations Division
C NT FLORIDA - 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
Cg5. 4c) 09-0cf coo 1
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a FinalDevelo ment Permit. In
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accepting this Final Development Permit, BP Number e, S062-, 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. .
Cecrro yb s
Property Owner Name(P ease Print)
p .
4: 6. 10
•rope % Owner Signature Date
STATE OF FLORIDA,COUNTY OF , + exfre...44.....)
ACKNOWLEDGED BEFORE ME THIS "IC DAY OF rn .20/(
BY 1 ( Ya ,LH�IS ERS ALLY KN69VN TO ME(0)OR WHO HAS
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PRODUCED • ...�i1/fl
( AS IDENTIFICATION.
SIGNATURE OF NiARY I:LIC TYP: •R PRINT NOTARY kCr �� - /'
COMMISSION NUMBER
(SEAL)
• 1
RIfDR"B.HU WI R74T12
SLCPDSD Revised 04/11/2011 +�,,N.% M4 ri ECOMMS M h U 19
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