HomeMy WebLinkAboutFilled Land AffidavitSLCPDSD Revised 0411112611
PLANNING & DEVELQPMNT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,.FL 34982.5652
(772) 462-1553
FILLED LAND Ak'k'ITIAVIT
• I
I, the undersigned, am -the owner ofthe following'described property,
(Parcel I& 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 propecty, and in accordance with Section
T04.01(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,
Pfoperty 04- IW d (Please Print)
Property Oivner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF20_,
gy ��AJt`li�`2A� WHO IS. PERSONALLY KNOWN TOM C�:b ORWHO HAS
PRODUCED
SIGNATURE OF NOTARY PUBLI
3�55� COMMISSION NUMBER
5 vie, KAREN VONOFRIO
MY COMMISSION # GO, 237658
_:'•` EXPIRES: August 5, ,2022
Sonded Thru Notary Pubric Underwriters
AS IDENTIFICATION.
,:.: n -, c3l e..�� ov\ 0 s- si l�
`' WE OR PRINT NOTARY
(SEAL)