HomeMy WebLinkAboutFilled Land Affidavit li
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
- Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
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FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
Lfays- 6ct,2ty r ,-4-v2ws r 2T-
�3/3-�D�—ODS3-(�Ob1 �vGi17Ay P�rt1ES sfA-&A,-9-.227_— La?'4196
(Parcel Id#/Legal description/Address) C wt A P/'1/p 70)(6Q 3 7 0
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.
Property Owner Nam (Please Print)
S-16-a
Pro rty OnZenignature Date
STATE OF FLORIDA,COUNTY OF
ACK OWLEDGED BEFORE ME THIS DAY OF Had 120r7d
BY VN c WHO IS PERSONALLY KNOWN Tn (_)OR WHO HAS
I I �� ��N
PROU ED AS IDENTIFICATION.
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SIG AT OTARY BLIC TYPE OR PRINT NOTARY
� p _ COMMISSION NUMBER
(SEAL)
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c1W PIK Notary Public State of Florida
SLCPDSD Revised 04/11/2011 ? Kayiin J.May
My Commission GG 908881
% w� Expires 10103/2023
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