HomeMy WebLinkAboutFilled Land Affidavit y. .. PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED_
FORT PIERCE,FL 34982-5.652
(772)462-1553
FEB 0 8 2019
FILLED LAND AFFIDAVIT ST. Lucie County,.Permitting
I,the undersigned, am the owner of the following described property,
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(Parcel Idg/Legat description/Addres§)
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 Owner Name(Please Print)
Property Owner Signature Date _
STATE OF FLORIDA,COUNTY OF
—4-�U ej If,
ACKNOWLEDGED BEK=Rf_�Atj'
THIS_S1`DAY OF 20A,
BY '< pkv WHOIS PERSONALLY KNOWN TOME(12 OR WHO HAS
PRODUCED _ AS IDENTIFICATION.
1 j
NATURE OF NOTARY P09Lic
o"aY1111" KAREN S. NIELSEN
COX IISSIONN `'� � State of Florida Notary Public
=* •= Commission # GG 207484
�'�;;,a�' My Commission Ezpiro(!S )
June 12, 2022
SLCPDSD Revised 04/11/2011