HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
S Building& Code Regulations Division
_ 2300 VIRGINIA AVENUE
�- — FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
i
I,the undersigned, am the owner of the following described property,
Icy 30 IN-0aoa-oo(S-5
(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.
h?l4�dLYIJ InWIX
Property
yOwner Name(Please Print) /
Propeky Owner Sfibnature Da
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF_ '` Y 20 /
BY �1/��/Lyt1 �/� WHO IS PERSONALLY KNOWN TO ME(1�1 OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNA URE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
FP-13 19/0 COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 2o`�vrugo CYNTRIA BAKER
MY COMMISSION#FF231810
� ENp1RES.June 29,2019
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