HomeMy WebLinkAboutFilled Land Affidavit7
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 thefollowing described property,
S) a v �, I b& 1 Ave .
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 forth,
adequate drainage off my property which will not adversely affect the immediate
community.
4 e ¢v1�A
Pro or 1 ame Ke int)
Property Owner Signature CNo Date
STATE OFFLORIDA, COUNTY OF S�.0 XA_
ACKNOWLEDGED BEFORE ME THIS DAY OF 20 LA
BY Chn5 ?o h5ol.At WHO IS PERSONALLY KN TOWN OME(I Ii OR WHO HAS
1fo DQI Qdr!(b
TYPE OR PRINT NARY
COMMISSION NUMBER
SLCPDSD Reviud 04/112011 EBE
lic State of dillossion GG 003/21126
(SEAL)
IDENTIFICATION.