HomeMy WebLinkAboutFilled Lands Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Y COUNTY Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 RECEIVE
FILLED LAND AFFIDAVIT 7sT. Lucie
UL 0 3018
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 14nal Development Permit. In
accepting this Final Development.Permit, BP Number K01-6063 , 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.
r cd'
Property O er Name(Ple se Print)
P erty Owner Si ature Date
STATE OF FLORIDA,COUNTY OF MQ4T�
ACKNOWLEDGED BEFORE ME THIS _DAY OF JWLe .20 /9
BY /� {f /-AP VL'k) WHO IS PERSONALLY KNOWN TO ME )OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNAT OF NOTARY PUBLIC TYPE OR PRINT NOTARY
66 11091,934 COMMISSION NUMBER
i HEMA.BROWN
WCOMMISSION#t3(i low
EXPIRES:Jmwery$2022
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SLCPDSD Revised 04/11/2011