HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
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Building&Code Regulations Division
'- 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
'= PCE19ED
FILLED LAND AFFIDAVIT PES Ay '2020
i.ucie County, Permitting
I, the undersigned, am the owner of the following described property,
4-1
( ) 0 e. it or r 7 Pt v c t �� d
(ParcelId#i egal descrip n/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.
Pty OwneT��2ne(Please Prin
i1 o
(P;roerty Owner Signature Date
STATE OF FLORIDA,COUNTY OF:&\r. \_t;&_ N K
ACKNOWLEDGED BEFORE ME THIS VS DAY OF 'M►q 20ka
BY Q q�'�\C��'1 �'�► Q'f s h WHO IS PERSONALLY KNOWN TO ME(0}OR WHO HAS
PRODUCED �l. ��s _ AS IDENTIFICATION.
SIGNATURE O�Y PUBLIC TYPE NAMARIEWEtii'
��C's0aaa�•3 COMMISSION NUMBER ar ;� My .OMMISSION#Go622OZ3
EXPIRES:December%2=0.
ed NotwlPublic Umlecwritem
SLCPDSD Revised 04/11/2011