HomeMy WebLinkAboutFilled Land Affidavit 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 owner of the following described property, ff
i5� SE �NE-ro ��ar �. 5►. L���c �� �tgy3
(Parcel Id#/Legal 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 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.
Property Owner Name(Please Print)
- - ���c__2
Property Owner Signature Date
r
STATE OF FLORIDA,COUNTY OF
4f
ACKNOWLEDGED BEFORE ME THIS_ DAY OF 2011-
BY� RV;J � _ WHO IS PERSONALLY KN N TO ME Q OR WHO HAS
PRODUCED / �' la AS IDENTIFICATION.
SIGNATURE OF NO RY PUBLIC TYPE
APRINT NOTARY
COMMISSION NUMBER
(SEAL)
e4`• Y Py i AUDREY B.HUMPHREY
:.: . MY COMMISSION#FF 174772
SLCPDSD Revised 04/11/2011 . s EXPIRES:March 6,2019
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••fi,yF Nq.• Bonded Thru Notary public Underwrders