HomeMy WebLinkAboutFilled land aff PLANNING &DEVELOPMENT SERVICES DEPARTMENT
c 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,
(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 \-%1151' MaCo I , 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.
ow""("Co,
Property Owner Name(Please Print)
Property wner ignature Date
STATE OF FLORIDA,COUNTY OF S `-V Z.\
ACKNOWLEDGED BEFORE ME THIS ate_DAY OF JVN q r 2011
BY � C�AIr r a C.\A% L 0+�r'N� WHO IS PERSONALLY KNOWN TO ME L )OR WHO HAS
PRODUCED �'" �• AS IDENTIFICATION.
SIGGN•��AppTURE+OF N ARY PUBLIC TYPE OR PRINT NOTARY
�►�brJ� 1��COMMISSION NUMBER DEANi
=ot ., M1s13SSI GIVENS
G 022023 f3
v EXPIRES:December 16,2020 l
Bonded Th,Notary Pubife Under+rtcrs'
,S,.a••' j
SLCPDSD Revised 04/11/2011