HomeMy WebLinkAboutFilled Land Affidavit . f
RECEI ;,BAR 0 017
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,
062-501- 060$ - 000-i /2606 Ne-}les glvA. �chscr 9C(kchXrL M-gi5l
(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 ' 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.
Fl�611 e[ k x
Property Owner Name(Please Print)
Property Owner Signature e Date
STATE OF FLORIDA,COUNTY OF �7C - Lt✓
ACKNOWLEDGED
/BEFORE ME THIS � DA F -41&a C4 20�
BYhr�I !a'l � J�L WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
AS IDENTIFICATION.
S1673-ATURE10F NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
CHRISTINE MATOS (SE )
Q°y4q.
a �;-; Notary Public•State of Florida
•= Commission#►GG 007074
s d' My Comm.Expires Oct 1.2,2020
Bonded through wionxl Noluy Assn.
SLCPDSD Revised 04/11/2011 _