HomeMy WebLinkAboutFilled Lands AffidavitPLANNING & 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,
1301-613-0158-000-1 7103 WINTER GARDEN PKWY Fort Pierce FL 34951
(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.
PMrKk 6 ll e9ie
Property Owner Name (Please Print)
FAA 64&6 �
iPmnentva(�wner Siia'Tature Date
STATE OF FLORIDA, COUNTY OF L Y A � f 1� LU CA v
AC t WLEDGED BEFORE ME THIS _IDAY OF I W 01 �� , 20
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1
By I WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIG14ATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
OCOMMISSION NUMBER
RARISSAWARE
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�. ea SondedTlw Notary Public Undeiwritent
SLCPDSD Rcviscd 04/11/2011