HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
o - Building&Code Regulations Division
_ w 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, `
J A g0 r 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
rr: 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 foie,
adequate drainage off my property which will not adversely affect the immediate
community.
Pr per Owner Name(P se Print) e
Property er Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF ®G�� ,20 j
BY K4 AFL 9gRa1- QeW' WHO IS PERSONALLY KNOWN TO MEAgb OR WHO HAS
PRODUCED AS IDENTIFICATION.
GNAATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
GC9 ! �COMMISSION NUMBER
(SEAL)
- - - - - - -- - - - - - -- -
JAMESA WETHINGTON,.R.
SLCPDSD Rcviscd 04/11/2011 Notary PuMIc,State o1 Floft
Commission No.GG319M
ans:' Commission EWM 04M4rM