HomeMy WebLinkAboutFilled Land 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,
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(Parcel IdN/Legal description/Address) I (QO $ F, n,e_ CUnP
RECEIVED
JAN�
ST. Lucle County, PermittIng
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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.
PropPerty Owner Na lea/spe Print)
x�cy�A U A ,PVD �ao
Property Owner St gn
iture Date
STATE OF FLORIDA, COUNTY OF U LU-C-t, a
ACKN—{O—W-LEDGED BEFORE ME THIS DAY OFI1i t/I.U[l�l(ut _ , 20 oW ,
BYLU r 6 _S WHO IS PERSONALLY KNOWN TO ME L_) OR WHO HAS
PRODUCEDAS IDENTIFICATION.
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SIGN URrE`OOpF NOTAIZYL,PU13LIC TYPE OR PRINT NOTARY
`IU COMMISSIONNUMBER
s ty, Notary is Stale of FlonCa
Francenene Newman
(SE My Commission GG 221434
Expires 05/23/2022
SLCPDSD Revised 04/11)2011 '