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PLANNING &DEVELOPMENT SERVICES DEPARTMENT
- Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
RECEIVZD JAN 31 g31
FILLED LAND AFFIDAVIT
I
I,the undersigned, am the owner of the following described property,
(Parcel Id#/L.egal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number %1ON-OSj,fA , 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 O er Name(Please Print)
P rty O Signature Date
STATE OF FLORIDA,COUNTY OF 45/1-i N L u C
5�
ACKNOWLEDGED BEFORE ME THIS j DAY OF !4[Cc/1 20 LT ,
BY <O A K/,�Z_ d'/� WHO IS PERSONALLY KNOWN TO ME L__)OR WHO HAS
R DUCED �` AS IDENTIFICATION.
SIGNAT F NOT TSSI(ON
LIC TYPE OR P NOTARY
NUMBER =ryPub
NAN
JANS
of Florida123596ly 18,2018
SLCPDSD Revised 04/11/2011
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