HomeMy WebLinkAboutR Doty Filled LandPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
a! 2300 VIRGINIA AVENUE
FORT PIERCE, PL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
5504 Birch DR Fort Pierce, PL 34982 // 3402-609-0188-000-3
(Parcel Id#/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.
Cc5tV
Property Owner Name (Please Print)
s/iq /z-oZ-o
Iroperty uroer Signature Date
LiiCa i ,STATE OF FLORIDA, COUNTY OF^
. DAY OF 20^0 .
WHO IS PP.RSONATLY KN^IvN TO MF. fll/l) OR WHO HAS
J'kjEfDyCED AJ AS IDENTIFICATION.
ACKNOWLEDGED BEFORE ME THIS
SIGNATURE OFNOTARY PUBLIC TYPE OR PRINT NOTARY
-COMMISSION NUMBERc
ubiic State of Floridd
iieen M Wilson
My Commission GG 116567
Expires 06/20/2021
SLCPDSD Revised04/11/20II