HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
•
Building&Code Regulations Division
2300 vIRGn aA AvENuE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following,described property,
-76 sE R\d;5R LN 10 "- 39-1-7-7011-0061 -000 -7
(Parcel-Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Deve opment Permit. In
accepting this Final Development Permit, BP Number Z 00 g ®t��'�, 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)
Pro erty Owner Signature Date
STATE OF FLORIDA,COUNTY OF �� 1,u C C(2
ACKNOWLEDGED BEFORE ME THIS 0`�_DAY OF K3 0 ?f-n�P� 20
BY J Ve Q he(-N �'") Gr1 WHO IS PERSONALLY KNOWN TO ME )OR WHO HAS
PRODUCED AS IDENTIFICATION.
�4.
JATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
�� AG DONNA PADULA
Notary Public,.State of Florida
SLCPDSD Revised 04/11/2011 Commission#GG 315533
My comm.expires Mar.25,2023
mjT
•,ram,