HomeMy WebLinkAboutFilled land aff PLANNING&DEVELOPMENT SERVICES DEPARTMENT
L41*14A 21 k Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
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I, the undersigned, am the owner of the following described property,
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N30- aZI- aGO,;-- oc)515
(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.
Propqfty Owner N4=nk e e Print)
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ProperYy Owner Si a Date
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STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS < DAY OF 20
BYS Q r-r I vl i A'I )C WHO IS-PE.RSONALLY KNOWN TOME CO)OR WHO HAS
PRODUCED F L J M Sa O,� (pg 3(�`a� Q AS IDENTIFICATION.
14 n.. 4<4v-�4.,l
SIGNAT E OF NOTARY PUBLIC TYPE OR 9RIINT NOTARY
C—i�Iago�S$� COMMISSION NUMBER
(SEAL)
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,�v��iy Notary Public State o!Florida
`f� Karyn G Drawdy
SLCPDSD Revised 04/11/2011 My CommimAw GG 292585 '
orw Expires02/11/2023
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