HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building &Code Regulations Division
LSVMlgk
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
Fr-
(772)462-1553
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FILLED LAND AFFIDAVIT OCT 05
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Pe,-mifting DC-Partment ,
St- Lucie
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"Ic'6 C untY, FL
E90-�
1,the undersigned, am the owner of the following described property,
(Parcel IM/Legal des&lption/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.
Property IZ19AI
Owner Name lease Pr'v4
roperty Owner Signature Dat
STATE OF FLORIDA,COUNTY OF !SL
ACKNOWLEDGED BEFr ME THIS DAY OF 20
BYJ-!Ja kiA Ip L)e---) WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED irVLIN \1 01aL AS IDENTIFICATION.
SIGNATURE OF NOT Y PUBLIC TYP9 OR PRINT NOTARY
COMMISSION NUMBER
r BEVERLEY DOUGWi
Notary Public,State of Florida i.
Commission#GQ 3E'793
My comm.expires Oct.
SLCPDSD Revised 04/11/2011
-BEVERLEY DOUGLAS
.0
0' 6 ?o Notary Public,State of Florida
Commission#GG 38793
Mcomm.My Cexpires Oct.22.2020