HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 T V r�i Ll
(772)462-1553
FILLED LAND AFFIDAVIT COU11ty, Permitting
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I,the undersigned, am the owner of the following described property, 10 'q
3
IT 7t4&c - 7/ �-t)h rd 8 4!1 16 , B
(Parcel ld#/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 WELL 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.
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PR-66--Fiy Owner Signature Date/
STATE OFFLORIDA,COUNTY OF �aI69 7
ACKNOWLEDGED BEFORE ME THIS J DAY OF- V\
BY e3N*-�R-^ WHO IS PERSONALLY KNOWN TO ME ZbOR WHO HAS
PRODUCED' AS IDENTIFICATION.
�Y y1\
SIGNATURE OF�NAR PUBLI�C � TYPE OR PRINT NOTARY
COMMISSION NUMBER
DEANpj
my comp'll, Jai is i C'
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B,),ndcd IN
SLCPDSD,Revised 04/1112011