HomeMy WebLinkAboutBuilding permit app PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1, the undersigned,am the owner of the following described property,
5-205 610
0
(Parcel IdXLepl desrrlpfion/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.
+0�u4lt' ePrint)
Date
STAIEOFFLOWDA,COINTYOF e Cp'J"*A \_,,
&ACENOWLEDGEDBEFOREME]TM
TS O> ) DAYOF NnJC�J/`I —20 20 ,
BY �I„��1�yCr r/ta.Cl�CC WHO ISIPERSONALLY IOVOWN TO ME(El OR WHO HAS
PRODUCED�IA 7AbJ _J63-4'1 '�SO - 2 _AS IDENTIFICATION.
/")tLCOI^IISSIONNIA4BER
�O� 'mfn"fG1
SIGNT Y PUBLIC TYPE OR PRMT NOTARY _..
(SEAL)
[!K=
SLCPllSDRcvised04/112ml