HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
__• _ 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
9-051VE-
FILLED LAND AFFIDAVIT SEP 2 9 23,
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
(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.
Property Owner Name(Please Print)
27A:��_A_� — — q I
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF1T �,� 12P J
BY �A2�a ,T W&k 5 WHO IS PERSONALLY KNOWN TO ME(LSF)OR WHO HAS
PRODUCED �` /LI I!-�,( L(� �s I AS IDENTIFICATION.
�GNA URE OF NOTARY PIC / TYPE OR PRINT NOTARY
COMMISSION NUMBER
•jo::PY Pf ., DIANAGOLDMAG 118P'I-)
°; Commission#G
N Expires July 27,2021 8� �7019
%;e of a°' Bonded Thru Troy Fain Insurance
SLCPDSD Revised 04/11/2011
DIANA GOLDMAN
Commission#GG 118888
Expires July 27,2021
Bonded Thru Troy Fain Insurance 800.385-7019