HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
ICOUNTY Building& Code Regulations Division
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,
3 `��sc b �� �a 1 14ta L`►e bt? . rJowr sT, Ltic i
(Parcel Id#/Legal de cription�resdAd s)
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.
9jC1'4ah Cyn
Property Owner Name(Please Print)
-�ef:V � .S— 1
Prop rty Owner Signature Date
STATE OF FLORIDA,COUNTY OFO Z'-"�
ACKNOWLEDGED BEFORE ME THIS_�DAY OF 20 (-(
BY rn WHO IS PERSONAL Y KNOWN TO ME(CEI)OR WHO HAS
PRODUCED I I �1 C� -.AS IDENTIFICATION.
'Q—Acooey C;V.
SIGITATURE OF NOT Y P LIC TYP R PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
;oars!eya(.: AUDREY B.HUMPHREY
COMMISSION#GG 300817
EXPIRES:March 6,2023
2,onded Thru Notary Public Underwriters