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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,
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2�Z1 -SOt - o01�1 - oSo- I 2 5 JL( hr 14�r �C�
(Parcel Id#/Legal description/Address)
�.-7o.6b i-E�T b� 1�i 7) .BLou4 B)
G-e-. } =mac EbD.' '1.1S. -f- LSr L-•forw`h�icf Ihaveapphier toSt. Lucie'County or a al Development Permit. In
accepting this Final Development Permit, BP Number /7d/- o 2gr, 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.
U 11 C.-1
Property Owner Na a(PI e a Print)
-PA-/n n . -25
�� 17
Property O wllS a e Date
STATE OF FLORIDA.,COUNTY OF 4jm 2�C�
ACKNOWLEDGED BEFORE ME THIS_�DAY OF ,20 / 7 ,
BY l i Ct✓�� h 71 WHO IS PERSONALLY KNOWN TO ME L )OR WHO HAS
PRODUCED EL I�Yf VeY /�CPKSe AS IDENTIFICATION.
K2A-�� x��'-X� A/>^(n2 L h C1 a y
S GN/A�TURE OFF N'OTAR PUBLIC TYPE OR PRINT NOTARY
G G U 4 75FIOMMISSION NUMBER
SEAT) MICE LANDAU
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No(uy Public-State.ot Florida
; Commission N GG 047593
My Com;n.Expires Nov 15,2020
SLCPDSD Revised 04/1 I/2011
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