HomeMy WebLinkAboutFilled Land Affidavit I I
�.� PLANNING &DEVELOPMENT SERVICES DEPARTMENT
COUNTY Building& Code Regulations Division
a 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 dFB
� SFr
(772)462-1553
FILLED LAND AFFIDAVIT 0°A,�
4 P
I �
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 tcto , 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. II
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.
1/43 rProperty Owner Name(Please Print)
Prop ty O a':1 Signature Date
t I,
STATE OF FLORIDA,COUNTY OF S1�Zr C- .
ACKNOWLEDGED BEFORE THIS Co DAY OF 1 JL3 20 1 `
BY 3e- WHO IS PERSONALLY KNOWN TO ME(C7)OR WHO HAS
PRODUCED PL- AS IDENTIFICATION.
CUM
Cek
SIGNATURE OFFOTARY PLIC' T OR PI (NOTARY��teSA h
6 \\
�J? COMMISSION NUMBER
ELLEN VAUGHNI
hlinki %State of Florida-Notary Public
Commission# GG 270079
; 'F'„:' My Commission Expires
,'"1,A 0 October 22, 2022
SLCPDSD Revised 04/11/2011 era