HomeMy WebLinkAboutFilled land aff i
G PLANNING & DEVELOPMENT SERVICES DEPARTMENT
a Building&Code Regulations Division
2300 VIRGI IA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
OGa 065`5
(Parcel Id#/Legal description/Address)
i
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 drainaget qo 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.
Proper er Na a Ie Print)
/a-/z-Zd
Prope er Sipat Date
STATE OF FLORIDA,COUNTY OF S7 y
ACKNOWLEDGED BEFORE ME THIS Z- DAY OF DGj— 120 2 O
BY, -7QYI X ^^ 1QWHO IS PERSONALLY KNOWN TO ME E OR WHO HAS
PRODUCED L�L" M 50°0 1 V-1��V AS IDENTIFICATION.
SIGNAATTUR OF NOTARY PUBLIC TYPE 0 T NOTARY
66(ga���COMMISSION NUMBER
Ae Pig,
Notary Pubffc Stste of Florida
Karyn G Drawdy
My Commiselon GG 282585
SLCPDSD Revised 04/1 1 20 1 1m a Expires 02/11/2023