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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
9161 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,
/Y1b/�+e Carlo Cote. 13/b b'-e/1
D 8-J)00-6
(Parcel Id#/Legal description/ Tress)
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. ,
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operty Own ame(Please Print)
I 2� �-
Property O ign Date
STATE OF FLORIDA,COUNTY OF y Uu C—
ACKNOWLEDGED BEFORE ME THIS 2- 0 DAY OF
`C l WHO IS PERSONALLY KNOWN TO ME UZR WHO HAS
PRO ED AS IDENTIFICATION.
1ZA 6L C , vr e�
SI T OF N Y PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
Rebec ff thla
Commission 0 GG060876
MAExpires: January 9 2021
141A;,�����`''� Banded thru Aaron Natary
SLCPDSD Revised 04/11/2011,