HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 RECEIVED
FILLED LAND AFFIDAVIT JUN.20 2019
ST. Lucie County, Permitting
I,the undersigned, am the owner of the following described property,
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(Parcel IM/Legal description/Address)
for which I have applied to St. Lucie County for aF' al 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 Nam e eft t
� or
roperty Own r Sign a Date
STATE OF FLORIDA,COUNTY OF L
P �
ACKNOWLEDGED BEFORY ME THIS Q-DAY OF 120_L�l�� ,20_ 9
WHO IS PERSONALLY KNOWN TO ME L_)OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGN URE 0 Y PUBLIC T E OR PRINT OTARY
CO
KAREN S. NIELSEN
State of Florida-Notary Public (S
*_ Commission # GG 207484
My Commission Expires
� ii..... June 12, 2022
SLCPDSD Revised 04/11/2011
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