HomeMy WebLinkAboutFilled Land Affidavit_ PLANNING & DEVELOPMENT SERVICES DEPARTMENT
1 � W - Building & Code Regulations Division
2300 VIRGMA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
1418-123-0030-000-3, 5000 Southwind Trail, Fort Pierce, FL 34951
(Parcel Id#/Legal 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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Pro Owner Signature Mile
STATE OF FLORIDA, COUNTY OF �,! , L--L4- CA LV-
ACKNOWLEDGED BEFORE ME THIS '� DAY OF 20
BYY�►�/�k1l WHO IS PERSONALLY KNOWN TO ME �20 WHO HAS
PRODUCED l .Ir �.+ ' ��5 L `�� , , ,,o { 3�' �(7 2 �_ AS IDENTIFICATION.
SIG O NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
(SEAL)
ASL�AMM M IUSSAIN
MY COMMISSION # 00961039
,Fads EXPIRES: Apr#09, 202,