HomeMy WebLinkAboutFilled Land Affidavit PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 RECEIVED
(772)462-1553
M A R 2 2
FILLED LAND AFFIDAVIT
ST. Lucie county, Permitting
1,the undersigned, am the owner of the following described property,
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(Parcel ld#ALegal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number VW6Q% 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, ormaintainin any form,
adequate drainage off my property which will not adversely affect the immediate
community.
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XPsPpeqy Owner N me(Pie Print)
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Property Owner Signature # Date
STATE OF FLORIDA,COUNTY OF 6�,
ACKNOWLEDGED BEFORE NiF THIS a a DAY OF 20—AA—,
BY LoS'-%01--50^YIN U I\ WHO IS PERSONALLY KNOWN TO ME(12 OR WHO HAS
PRODUCED rC L L AS IDENTIFICATION.
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*'���SIG=ATURE
SIGNATURE OF �ARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER DEANNA MARIE GIVENS
MY COMMISSION#GG 022023
V! t7f EXPPEW00mmber 16 2020
13oridedThruNotary P,bi!rUnderwNte,-.,
SLCPDSD Revised 04/11/2011