HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
• _ 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 [—RECEIVED
FILLED LAND AFFIDAVIT AUL 0 34188
ST. Lucie County, Permitting
I,the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County fora alDevelopment Permit. In
accepting this Final Development Permit, BP Number 01 ab 53 , 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.
co r
Property Oyfier Name(Ple se Print)
LmIvZr—,�-- 4;;i
P erty Owner Sijnat&e Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS_ DAY OF J&-Xe 20 (a
BY �/� / /�� /✓4!7601 WHO IS PERSONALLY KNOWN TO ME(BrOR WHO HAS
PRODUCED AS IDENTIFICATION.
16769t-
SIGNATURf OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
HERYLA BROWN
*_ MY COMMISSION#GG 168639
EXPIRES:January 2,2022
BN&d Ttw Notary MW UMetw bM
SLCPDSD Revised 04/11/2011