HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
err 2300 VIRGINLA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
�lo9 �- noo 3 51 My Sirj'I,P r
;Parcel Idt1/Leval d'
b
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
acknowle
that as owner of the above described property, and in ad a-e I with Sectdion
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.
-W 6do m S
Property veer Name (please Print)
\ N y vwrrerbigiature I 2 v
Date
STATE OF FLORIDA. COUNTY OF S t I lit ( I i
ACKNOWLEDGED BEFORE ME THIS /i�TO
DAY OF l/BY_20�WHO IS PERSONALLY KNOW
PRODUCED ME OR WHO HAS
11,E Al AS IDENTIFICATION
S NATUREOFN FAR UBLIC �Itt "AP` nln� JO�Nj0M
TYPE OR PRINT NOTARYV
I COMMISSION NUMBER
(SEAL)
Revised 04/11/2011
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