HomeMy WebLinkAboutFilled land affidavit 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,
0/4 Y
(Parcel Id#/Legal description/Address)I11 LIA5— `703-
for
03-for which I have applied to St. Lucie County for a Final Development Permit. In .j
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
communy.
V E
roper Name(Please Print)
Il / (J
P 4 O r Signature Date
STATE OF FLORIDA,COUNTY OF (<3-I - LIQ O(L
ACKNOWLEDGED BEFORE ME THIS 1 DAY OF 1200%
BY :bGL v 1,L\ P,(A- �`C 4 WHO IS PERCONALLY KNW3MUZQ r�.rc C�6 OR WHO HAS
PRODU ED AS IDENTIFICATION.
KCS,
GNAT O ]N ARY PUBLIC TYPE ORP T NOTARY
C670 ` OMMISSION NUMBER
(SEAL) j
Notary Public State of Florida
SLCPDSD Revised 04/11/2011 Kaylin J.May
1• My Commission GG 906981
��OF Fu Expires 10/03/2023