HomeMy WebLinkAboutFilled Land Affidaviti
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,
IL3// - 30/- ooai_ coo-3 53 3 &, yiened + P) r{
(Parcel Idle/Legal description/Address)
for which I have applied to St. Lucie County for i a Final Development Permit. In
accepting this Final Development Permit, BP Number I acknowledge
that as owner of the above described property, land in accordance with Section
7.04.01(D), St. Lucie County Land Development Coc
adequate drainage so that the immediate community
I further acknowledge that in granting this permit fc
St. Lucie County is neither obliged nor liable to pr
adequate drainage off my property which will n
community.
,l illiam &to'n gdams
Property Owner NaMe (Please Print)
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Property l�Slgnature Dafte
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STATE OF FLORIDA, COUNTY OF L lirn f tlLrl O
I shall be responsible for assuring
VILL NOT be adversely affected.
the development of this property,
'ide for, or maintain in any form,
adversely affect the immediate
ACKNOWLEDGED BEFORE ME THIS Iq DAYOF /VeUOivlba/ 20—Z9�
BY �//hem roan Adamc WHO IS PERSONALLYKNOWN TO ME C WHO HAS
PRODUCED
�� SICiNNAAT�UR�E� OF NOTARY PUBLIC
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(��6'.7__i/POY COMMISSION NUMBER
SLCPDSD Revised 04/1112011
PT7
IDENTIFICATION.
PATRICIA(gAgNALN GRIFFIN
MY COMMISSION A OG137624
EXPIRES September 26,2021
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