HomeMy WebLinkAboutFillled land aff z PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
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.
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Prope er Name Print)n
L ZO
Prope er Signat&tl Date
STATE OF FLORIDA,COUNTY OF Lo G L`e
ACKNOWLEDGED BEFORE ME THIS r/Z DAY OF 20 20,
BY M'Y►t X WHO IS PERSONALLY KNOWN TO ME CO OR WHO HAS
PRODUCEDGL �L M'�ao'1�1-10$"3�l'O AS IDENTIFICATION.
-� � .`Jha� �O► ✓1� 17c�a�
� S�IGNNAATrU�RE F NOTARY PUBLIC TYPE RINT NOTARY T'1rJ ld�'S-i��J COMMISSION NUMBER
ryr ru Notery Public State of Florida
,p KaMt G Drawdy
My Commissio0�292585
Exores ov
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SLCPDSD Revised04/11/2011