HomeMy WebLinkAboutFilled Lands i
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I
I,the undersigned, am the owner of the following described property,
-O All yaU .�i-
(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.
tis�re(IQ 06 Ian o,
Property Owner a(Please Print) _
(O 7D
Property Wnlf gignature Da a
STATE OF FLORIDA,COUNTY OF e
ACKNOWLEDGED BEFORE ME THIS DAY OF •20
BY Cl I♦�� WHO IS PERSONALLY KNOWN TOME(ElOR WHO HAS -
f�
[-'C44)PRODUCED_ (J�'�<<1 C AS IDENTIFICATION.
�77GN URE O PUBLIC TYPE OR PRINT NOTARY —...
P9 0 40'14 COMMISSION NUMBER
(SEAL)
BRENDAN �GdlsB�i_1`'�°
'- - MY COMMISSION#FF960076
,uT,d�, EXPIRES February 11.202()
SLCPDSD Revised 04/11h011 l400 ase 0•5:s FlortdallolarySe[wr.e.roir
I
I
_ ^ }a .
2SO
oate �\
-
{\ t% A