HomeMy WebLinkAboutFilled Land Affidavit t;
s $ I PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED
i
FORT PIERCE,Fl,34982-5652
(772)462-1553 I
JAN 14 "0"!'
FILLED LAND AFFIDAVIT S'. Lucie County, Permitting
I,the undersigned, am the owner of the following described property,
-tya o4 -ao45-<-)10 -
(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 ago 1-y aj�, 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, of maintain in any.form,
adequate drainage off my property which will not adversely affect the immediate
community.
Pry7efy Owne ame(Please Print)
_"n'l i YAJAA
Property caner Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS —DAY OF
By *_G�.I,1 WHO IS PERSONALLY KNOWN TOME(ElOR WHO HAS
PRODUCED �' �' AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC T O1 NOTAL NNA MARIE GIVENS �
MY COMPJIISSION#GG 022023 GS
COMMISSION NUMBER EXPIRES:December 16,202-0
p° -?8 Bonded Yhru Notary Public Undenvrlters .
SLCPDSD Revised 04/11/2011