HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
L 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,
(Parc d#/Legal description/Address) &17'r? car/fO n e aM 5 izo
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.
d �A (A X111 MeIVI r r
n
Property Owner Name(Please t) /
zAln
U d
P erty Owner Signature D e
STATE OF FLORIDA,COUNTY OF
ACKNOWL DGED BEFORE ME THIS v DAY OF O' ZORWHO
BY Is PERSO L OWN TO MEAS
PRODUCED — _ S IDENTIFICATION.
OF UBLIC TYPE PRINT NO
CO INUMBEItRENDA LEE LEA
Notary Public.State of Florida
Commission k GG 341965 (SEAL)
My Comm,Expires Jul 30,2023
Bonded through National Notary Assn.
SLCPDSD Revised 04/11/2011