HomeMy WebLinkAboutFilled Land Affidavit�J
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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,
990 G, OPli,Tr lL Iu IDCn,C P—D .
(Parcel Id#/Legal description/Address)
for which 1. have applied to St. Lucie County for a Final Development Permit. In
accepting this .Final Development Permit, BP Number orOIO' d3a6 , 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.
t�a, fan M14.h &
Property Mner Name (Please Print)
Property er Signature Date
STATE OF FLORIDA, COUNTY OF 54.
ACKNOWLEDGED BEFOREOME THIS 0% DAY OF C�06C 20 ZO
BY S0.v a.�.. G%^F 6— WHO IS PERSONALLY KNOWN TOME (II) OR WHO HAS
PRODUCED to-r:y4rS AS IDENTIFICATION.
A64co- LLeotr_
SIGNATMM5T NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
ALEXA KRATT
Notary Public State of Florida
Commission It GG 984139
SLCPDSD Revised 04/11/2011 �`;?g n� My Comm. Expires May 4, 2014
Bonded through National Notary Assn.