HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
COUNTY
• 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,
- e�o � -C - i��.1 2a - :1)=2
(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 20(32 , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St.Lucie County LandDevelopment 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. ''
ANS) ,� AJ N/i, C- 1E
Property Owner Name(Please Print)
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OFC-�l
ACKNOWLEDGED BEFORE ME THIS DAY OF "• / 20�v
BY ' 1 a'hL(3,k &.. e C L\�C 5W.0 IS PERSONALLY KNOWN TO (a OR WHO HAS
PRODUCED V t_ 5:L AS ICATION.
17
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
(SLD -7 O�O Q500 SSION NUMBER
(SEAL)
mEa1S
SLCPDSD Revised 04/11/2011 Expyrs OMM23