HomeMy WebLinkAboutFilled land aff PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I
I, the undersigned, am the owner of the following described property,
(Parcel ld#/LJegal 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.
rz Luna
Pro ty Owner Name(P e Print)
7 n
roperty Owner Signature Date
STATE OF FLORIDA,COUNTY OF —::�+ L U e e—
ACKNOWLEDGED BEFORE ME THIS ';�g DAY OF �GttJ��� 120 20
BY ?OEe 'G Y y1U 00 WHO IS PERSONALLY KNOWN TO ME G OR WHO HAS
PROIZUCED_F16k?U":L- 6aix11(pis GI } Al AS IDENTIFICATION.
SIGNATURE OF NOTKRY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
Notarization valldetas
signature only, :;�;�. HASSI A SArABRia
, =ate"�..
not document content Notary Public•State 4 Florica
SLCPDSD Revised 04/I 1/2011 'a," Commissior a GG 30327
orF` My Comm.Ezoires:u:Z8.2023
Boncec through Nanora:%otary Assn.