HomeMy WebLinkAboutFilled Land Affidavit I
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY 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,
-1 C'1C.Y�r1�l L
(Parcel Id#/Legal descriptio Address)
for which I have applied to St. Lucie County fora Final Develop ent Permit. _ In
accepting this Final Development Permit, BP Number , 1 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-C-ounty-is-neither-obliged-nor-liable-to-provide-foror-maintain-in-any-form, — -
adequate drainage off my property which will not adversely affect the immediate
community.
Property 04mer Name(Please Print)
Property-Owner Signature Vake
STATE OF FLORIDA,COUNTY OF V�
ACKNOWLEDGED BEFORE ME THIS DAY.OF .207�
BY WHO IS PERSONALLY KNOWN TO ME CEI
j OR WHO HAS
PRODUCED L- AS IDENTIFICATION.
SIGNATURE dFNOT Y LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
;ooYdJa;, KAREN S. E SEN
3= :State of Florida-Notary Public
_* *z Commission #GG 207484
�i��E My Commission Expires
SLCPDSD Revised 04/11/2011
"�i� "' June 12, 2022