HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
AUG 19 '2020
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
:36-l sVe CF( /0-lue
(Parcel Id#/Legal descripti /Address)
FT. P e-rCe P' 3RIV-a-
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.
AN &A A1/
Properly Owner Name (Please Print)
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Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF T ' \�
ACKNOWLEDGED BEFORE ME THIS `a" DAY OF
BY y� S2 �C WHO IS PERSONALLY KNOWN TOME ([a OR WHO HAS
PRODUCED
SIGNATURE OF NOT Y PUBLIC
C-46-4 6n+3 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
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TYPE OR PRINT NOTARY
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$�. DEANNAMARIE GIVt'NS
;,(SEAMY COMMISSION # GO 0?2023
EXPIRES : December 10, 2UZU
Bonded 7btu Notary pubftc Undenvrttam
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