HomeMy WebLinkAboutFilled Land Affidavit sr
PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Sr Lcreir ,,i- Building&Code Regulations Division
COUNTY•
FLORIDA 2300 VIRGINIA AVENUE'
. FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
Rf3) 00r)(4•—CCO/&)
(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 1,9,71'" , 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.
rt,-e_A4-0 -a,GLIt4d1
op W I er Name(Please Print)
_ ��1 . / ��
Pr ' 1 '
operty Owner Signature :ate
STATE OF FLORIDA,COUNTY OF `'�-Lucie
ACKNOWLEDGED BEFORE ME THIS-_l"7 DAY OF be G � ,20 /j ,
BY WHO IS PERSONALLY KNOWN TO ME(I2 O/R WHO HAS
PRODUCED D i - AS IDENTIFICATION.
/1. f1(9 ' Vc� ASIGNATURE OFNOTAR.� UBLIC TYP 0PRI NOTARY
G6 a77007(fOMMIISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 n SComm Florida Notary public
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