HomeMy WebLinkAboutFilled Land Affidavit(1j
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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,
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2'l274,01-0060- 00/0 �IrZ1gFwr eFt#7r /90-lr-? PI � P eacsFc .3s&9g 2
(Parcel Id#/IAgal 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 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.
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Pr �Own Name lease Print)
Property Owner Signature Date
STATEOFReORt9A,COUNTYOF Oar s.
AC OW ,D,GED BEFORE ME THIS 3 s� _ DAY OF 20 ZO
FOO _
/L t � •
O IS PERSONALLY KNOWN TO ME (El OR WHO HAS
COMMISSION NUMBER
SLCPDSD Revised 0411 I/2011
AS IDENTIFICATION.
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TYPE OR PRINT NOTARY
(SEAL)
VANCE KIRKWOOD
Notary Public - State of Michigan
County of Macomb
My Commission Eaplres Mar 18 202
Acting In the County of)a Wj AA�