HomeMy WebLinkAboutFilled Land Affidavit / G
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pLANNIPTG&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
COUNTY
, A 2300 VIROM AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553.
FILLED LAND AFFIDAVIT
I,the undersigned,am the owner of the following described property,
(Parcel I&Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP NumberQDD/o�(� ��`� , 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. WILT be adversely affected.
I further acknowledge that in granting this permit for the development of this.property,
nor liable to provide for, or maintain in any form,
' neither obliged p
Lucie Co Is -
St. L, County
adequate drainage off my property which will not adversely affect the Immediate
Community..-
• ��- � �l ia4S -
Property Owner Name lease
Property.Owner S' a Date
T
STATE OF FLORIDA,COUNTY OF S / - WC7�
ACKNOWLEDGED BEFORE ME THIS A—DAY OF .20
BY rdez- 771,Acy S/1-Ns WHO IS PERSONALLY KNOWNTOME(�R WHO HAS
AS IDENTIFICATION.
PRODUCED
TURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
�37p 7 COMMISSION NUMBER a�►*+"++ Notary Public State of Florida? Richard Alan Setnan
� � +,, My Commission GG 213797
0,Ito Expires 08/13/2022
SLCPDSD Revised 04/1 1120 1 1