HomeMy WebLinkAboutDechiaro Filled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGNIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-155"
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
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(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 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.
Propert Owner Name (Please Print) j
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Property Owner Signature Date
STATE OF FLORIDA. COUNTY OF
ACKNO�WL�EWED BEFORE ME TMS DAY OF SQ PVP-- , 20_QD _,
13Y Tp�nos��'i 0 WHO IS PERSONALLY KNOWN TO ME (✓) OR WHO HAS
PRODUCED
ISSION NUMBER
SLCPDSD Revised 04/111201 1
TYPE OR PRINT NOTARY
(SEAL)
AS IDENTIFICATION.
PY'�uG SHIRLEY LrFrLEFIELD
Notary Pubdc -State of Florida
Commission 4 GG 345251
My Comm. Expires Jun 13. 2023
Bonded through National Notary Asse,
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