HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 RECEIVES
(772) 462-1553
DEC 10 2019
FILLED LAND AFFIDAVIT Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
(Parcel IM/Legal
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.
.�ca� I�rtt��SC,LI
Property Owner Name (Please Print)
/a i�
Property Owner Signa4re Date
STATE OF FLORIDA, COUNTY OF < 111✓I � 114 CINC ^ �`/��
ACKNOWLEDGED BEFORE
,MMEETTMSS 16 DAY OF �l �201?
BY 1 1 A;2 US 'cJhq_9! iN WHO IS PERSONALLY KNOWN TOME Q OR WHO HAS
IDENTIFICATION.
OF NOTAXI P&MC TYPE OR PRINT NOTARY
COMMISSION NUMBER
"'.
KAREN S. NIELSEN (SEAL)
State of Florida -Notary Public
-`_ Commission # GG 207484
2 4y M Commission Expires
SLCPDSD Revised 0411 U2011
°'%°nJune 12, 2022