HomeMy WebLinkAboutFilled Land Affidavit I
kms- a 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,
20 RMQ V 344 �O/ NO 136-0 0
(Parcel IO 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 �ZQ O5'Q-'�tPI 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.
Property Owner Name(Please Print)
Property OwAr Signature Date
STATE OF FLORIDA,COUNTY OF SLI-UO G
ACKNOWLEDGED BEFORE ME THIS ' DAY OF HAY AY 202-0 ,
BY 0KH'D bG�Ve VI{e WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
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PRODUCED L, AS IDENTIFICATION.
mac - oa-�tx
SIGNATURE OF NOTARY PU9LIC TYPE OR PRINT NOTAR
COMMISSION NUMBER
(SEAL)
vsr P Notary Public State of Florida
Nichols Aponte
MY Ccmmissm GG 983216
SLCPDSDRevised04/11/2011 ' as EXpire50510412024
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