HomeMy WebLinkAboutFilled Land Affidavit r i PLANNING&DEVELOPMENT SERVICES DEPARTMENT
o ' Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 RECEIVED ,
FILLED LAND AFFIDAVIT MAR 2 7-2019 f.
ST. Lucie County, Permitting
I,the undersigned, am the owner of the following described property,
(Parcel ld#/Legal description/Address)
for which. l 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.
=ProOwner Nam�Please Print)
Property Owner Signature D e
STATE OF FLORIDA,COUNTY OF LIQ c,'6 -
ACKNOWLEDGED BEFORE ME THIS DAY OF l( rd ' 0 l ,
BY C cmc)�r2- GVI,I.( 1 I WHO IS PERSONALLY KNOWN TO ME deOR WHO HAS
PRODUCED AS IDENTIFICATION.
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��a `ss lam' S S
�S1C�NATU)ZEOF NOTARY PUBLIC TYPt OR PRINT NOTARY
��yyll ((Ilff //��YY��I1`,,,M USSION NUMBER
: •, MY COMMI"ON N 7
''» ••., EXPIRES:AVq 2.2021
SLCPDSD Revised 04/11/2011 "' BMay= Nom Pu*V*f~