HomeMy WebLinkAboutFilled Land Affidavit 7i
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building &Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner of the following described property,
(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 2006J" 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.
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Prop Owner Name(Please Print)
r,,-,,P 126 ��1
Prop Owner
Signature Date lr
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS Ij DAY OF ne
er-1 ATS BY WA-Dba ZOL TATS NAS LLY KNOWN TO ME OR WHO HAS
PRODUCED AS IDENTIFICATION.
)at lw-p4lge
TYPE OR PRINT NOT*Y
SIGNATURE OF TARY PUBLIC
ft 3 n.
—COMMISSION NUMBER
(SEAL
DREY B.HUMPHREY
COMMISSION#GG 300817
My
EXPIRES:March 6 2023
SLCPDSD Revised 04/11/2011
Sanded Thru Notary Public Underweftr