HomeMy WebLinkAboutFilled Land Affidavit l � .. PLANNING &DEVELOPMENT SERVICES DEPARTMENT
s Building&Code Regulations Division
2300 VIRGINIAAVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following/described property,
(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 11 O� -0%O 0 , 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 OvAwr Name(Pleas .�r'�int)DD
/A,z/zz
roperty Owner Signature Da
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF a 20—u—
BY�Q%fN V'q 1 A q\ '1 'WHO IS PERSONALLY KNOWN TO ME C—)OR WHO HAS
PRODUCED AS IDENTIFICATION.
J 1J Q G V�y1q \V e Y�
SIGNATURE�40Y PUBLIC TYPE OR PRINT NOTARY
d5� COMMISSION NUMBER
MpRIE yp023
CAM ISSIO mbet 16,.2020
'•aF EXPIRES: ncUndetrnft�►s
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SLCPDSD Revised 04/11/2011