HomeMy WebLinkAboutFilled Lnads PLANNING&DEVELOPMENT SERVICES DEPARTMENT
COUNTY Building&Code Regulations Division
2300 VIRGRGA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
RECEIVED
FILLED LAND AFFIDAVIT 0 C T 12 �u!a
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 1110-0 a 1-3, 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.
ahJD 6
Property Owner. ame(Please Print)
Pr' erty 'r
Signature Date
a.
STATE OF FLORIDA,COUNTY OF Q,,
ACKNOWLEDGED BEFORE ME THIS P0 0 DAY OF V ter 20n—
BY 1 D NT:D O P—I a/d e 1WHO IS PERSONALLY KNOWN TO ME(El OR WHO HAS
PRODUCED I 1 ) L 1 n . AS IDENTIFICATION.
SIGN OF NOT PUBLIC TYVbRPRINTNOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
AUDREYB.HUMPHREY
MY COMMISSION#FF 174772
EXPIRES:March 6,2019
Bonded Thru Notary public Underwriters