HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 RECEIVED
1 FILLED LAND AFFIDAVIT APR 3 0 2019
\ ST. Lucie County, Permitting
I,the undersigned, am the owner of the following described property,
L1 q/q press I r (In. , (4- P U-e f mac- 3 yct$
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a F' al Develo ment Permit. In
accepting this Final Development Permit, BP Numbers - I acknowledge
that as owner of the above described property, and in 'acc6rdhnce 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.
JS ham,. I r �
Property Owner Name(Please Print)
Pr ope ignature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWL DGED BEFORE ME THIS DAY OF 20_1�L
BY LU eA WHO IS PERSONALLY KNOWN TO ME U OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE 0 LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL) i
KAR7iqotaryLSEN i
=?o State of Public
Commi207484I
Ply CoExpireSLCPDSDRevised04/11/2011J22