HomeMy WebLinkAboutFilled Land Affidavit Yn.4
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PLANNING&DEVELOPMENT SERVICES DEPARTMENT
MOM Building&Code Regulations Division
2300 VIRGINIA AVENUE
RECEIVED
—N& FORT PIERCE,FL 34982-5652 =R
(772)462-1553
MARR 2 Zo
AR 2 7 Z019
FILLED LAND AFFIDAVIT
ST. Lucie
Luce county, Permitting
1,the undersigned, am the owner of the following described property,
NQ00.k IVY.
(Parcel ldff/Lejal desiption/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting
ing 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 WELL 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)
Pyo-pe-4 Owner Signature Date
STATE OF FLORIDA,COUNTY OF
KNQWLEDGED BEFORE 4THIS C;>4 DAY OF
BY j)eQ 1190 IS PERSONALLY KNOWN TOME(a OR WHO HAS
PRODUCED L AS IDENTIFICATION.
0 1A
SITRATURE OF NOT PTYPE OR PRINT NOTARY
—COMMISSION NUMBI3PV_=.,,_,:;!,
KAREN S N
s t a t e 0 f A Or i da t N 11 ct-aL, blic
C ypu
Ornmission t GG 207484
My Cornmiss ion Expires
June 12, 2022
SLCPDSD Revised 04/11/2011