HomeMy WebLinkAboutFilled Land Affidavit G&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FMLED LAND AFFIDAVIT
1,the undersigned,am the owner of the following described property,
' A 1 11111111 `1, `1 1
(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 s 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 WILLN 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.
hl 49,ILYA) ' M//J I X
Property Owner Name(Please Print)
Prop elty Owner ature Daie
STATE OF FLORIDA,COUNTY OF
q�k q y
ACKNOWLEDGED BEFORE ME THIS
/ DAY OF tn
BY MRPLY� In/U IX WHO IS PERSONALLY KNOWN TO ME(I:- OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNAVURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 0411 U2011 r =oar s CY.NTRIA BAKFR
My COMMISSION g FP-31910
FMIRES:jIme 29,2019
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