HomeMy WebLinkAboutFilled Land Affidavit Slid
PLANNING &DEVELOPMENT SERVICES DEPARTMENT
COUNI y - Building&Code Regulations Division
F ,L X04 R .I:SA - 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
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(Parcel Id#/Legal description/Address)
for which I 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.
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Property Owner Name(Please Print/
' "V.Z;14%-Ali 0 I 91(1
Property Owner Signature / Date
STATE OF FLORIDA,COUNTY OF 51— L C.._
ACKNOWLEDGED BEFORE ME THIS DAY OF 2019 ,
BY WHO IS PERSONALLY�O ME( )OR WHO HAS
PRODUCED L_ _ AS IDENTIFICATION.
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V �� Ql�Vcuc
SIGNATURE OF yNOTARY PUBLI TYPE OR PRINT NOTARY
d lOV 4 OMMISSION NUMBER
(SEAL)
ELLEN VAUGHN
SLCPDSD Revised 04/11/2011
?*°�•74�sState of Florida-Notary Public
*_ Commission # G,G 270079
i;oP� My Commission Expires
October 22, 2022,.
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