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,
3,21'L4' a3 I— C)(::)O 06 0
ced 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 , 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 WELL 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 NAnle(Please Print)
S/14(ha
Propert;nCavre&_Signature Date
STATE OF FLORIDA,COUNTY OF �.
ACKNOWLEDGED BEFORE ME THIS T DAY OF 20 C)P
B IS PERSONALLYGOWN TO ME OR WHO HAS
PRODUCED AS IDENTIFICATION,
44 1
SIG A URE OF NIVRY PUBLIC T*,g OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
P, AUDREY B.HUMPHREY
MY COMMissioN#GG 300817
It'. EXPIRES:March 6,2023
to,
nde'd
1.11 00 Bonded Thru Notary Public Underwriters