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
JUL 13 ?01$
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 for a Final Development Permit. In
accepting this Final Development Permit, BP Number 1'361-03A3 , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D)5 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(Ple a Print)
Property Owner Signaturd Date
STATE OF FLORIDA,COUNTY OF�'
ACKNOWLEDGED BEFORE ME THIS \� DAY OF20 14
BY h�Me� L 4..nnP C Z WHO IS PERSONALLY KNOWN TOME ❑( IOR WHO HAS
PRODUCED N L AS IDENTIFICATION.
Qe,a r\v\o'
SIGNATURE OF NUFARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER n
D€AN! I:�Rr RE uIVENS .
INY CUfu?€aiS ui ).0 022023 p
EXPIRES:December 96.2020
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SLCPDSD Revised 04/11/2011