HomeMy WebLinkAboutFilled land affidavit 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 property,
described pertY,
Wy25- w-DOa3-000-� 20l$ NW r?oy�[. F�,e►J c7 P�t,M Cc� Ft 3�/9Qo
(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.
M (Cj*Eq 1460AP pEz.
Pro a Owner Name le se Print
P nY �r� )
�C�.���
Property er,Signature Date
STATE OF FLORIDA,COUNTY OF MA27r nl
ACKNOWLEDGED BEFORE ME THIS 2 DAY OF NOV E 114 �E 20 1 6
BY M ICKEy 14'EGZ 1JAN D£z WHO IS PERSONALLY KNOWN TO ME(--- OR WHO HAS
PRODUCED GEM&A D IL D 04W 71 a AS IDENTIFICATION.
Q.
SIGNATURE OF NOT PUBLI TYPE OR P I I` $Y MY COMMISSION#FF 928213
a EXPIRES:January 3,2020
COMMISSION NUMBER ?of 1?".•' Bonded Thor Notary Public Underwriters
(SEAL)
SLCPDSD Revised 04/11/2011
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