HomeMy WebLinkAboutFILLED LAND AFFADAVIT.� PLANNING & DEVELOPMENT SERVICES DEPARTMENT
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,
3403-702-0002-000-5
(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
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.
Gary Gardner
Prope Owner Na e (Please Print)
Property9Kner Signature
STATE OF FLORIDA, COUNTY OF 'E+ w C 1 e
Date
ACKNOWLEDGED BEFORE ME THIS v�5- DAY OF IJIJ� , 20 d2`0 ,
BYWHO IS PERSONALLY KNOWN TO ME 0 OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGNATURE OF NOTARY -PUBLIC TYPE OR PRINT NOTARY
QOMI05-COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
(SEAL)
BRIANNA GRAHAM
MY COMMISSION #GG089105
EXPIRES: APR 02, 2021
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I ®tided through 1st State Insurance