HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
a Building& Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE,FL 34982-5652
(772)462-1553 FEB 1 Y 2019
FILLED LAND AFFIDAVIT ST. Lucie County,Permitting
I, the undersigned, am the owner of theZ
ving described property,
�n�
(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 jgf)2. 41 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(P ase Print)
091/ 1?
Property Owner Signature Date
`l
STATE OF FLORIDA,COUNTY OF I
ACKYqWLEDGED BEFORE ME HIs 1t DAY OF 2019—
BY G,Grr�'fi e_ (/�L,� WHO IS PERSONALLY KNOWN TOME OR WHO HAS
PRODUCED FL AS IDENTIFICATION.
1 1
SIG URE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER „���, KAREN S. NIELSEN
1,StY P(,B�i
State of Florida Notary Public
�° Commission # GG 216744
rn Commission Expires
C9 My
y June 12, 2022
SLCPDSD Revised 04/11/2011