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,
- (:�6y_ GAcg-000-5
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a F' al Development Permit. In
accepting this Final Development Permit, BP Number 15 , 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.
"Me t& C2 woefiv
Property Owner Name(Pleatk Print)
- 01 & k t.
+PropertOwner TignaturO U IMte
STATE OF FLORIDA,COUNTY OF- 1-%)
ACKNOWLEDGED BEFORE ME THIS DAY OF 20 1�
BY Nal «1' Q `R 1 a WHO IS PERSONALLY KNOWN TO ME Q OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOT Y PUBLIC TYPE OR PRINT NOTARY
ie�� COMMISSION NUMBER Di=ANNA MARIE GIVENS
MY COMMISSION#GG 022023
EXPIRES:Dec(III&ALIS,2020
Bonded Thru Notary Puti;c l;rde w ite s
SLCPDSD Revised 04/11/2011