HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY Building&Code Regulations Division
FLORIDA - 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 F
(772)462-1553 , �1•,,p C ,6
SF 1444)• � ��01�
FILLED LAND AFFIDAVIT c'4 ex),
O(. 'd®fit
I,the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie Countyfor a Final Development Permit. In
PP P
accepting this Final Development Permit, BP Number 1010 a-0 l k3 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 abknowledge 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- Wyk L- c
14
ACKNOWLEDGED BEFORE ME THIS S DAY OF ` Irk 20 t I ,
:000
1 C. I/ Cc
BY i 1 �c '(V-Y1 G��� • WHO IS PERSONALLY KNOWN TO ME(❑)OR WHO HAS
PRODU ✓cJ AS IDENTIFICATION.
SIGNATURE OF NO ARY PUBLIC TYPE 0: ': - : 'sANDRA0014"
COMMISSION NUMBER ' ! comm ' ®1169
4 `' � re90eO1"4000.
WOOn
SLCPDSD Revised 04/11/2011