HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
2300 VIRGRZA AVENUE RECEIVED
FORT PIERCE,FL 34982-5652 -
(772)462-1553 Nnv 0 6`2020
FILLED LAND AFFIDAVIT Permitting
LucciDepartment
Co n Yent
I,the undersigned, am the owner of the following described property,
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(Parcel IM/Legal descriphon/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number'Zol/— P 0VI 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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Property Owner Name(Please Print)
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roperty Owner lgnature Dat
STATE OF FLORIDA,COUNTY OF 0,
`'
ACKNOWLEDGED BEFORE ME THIS DAY OF 1�3 O V 120 a��
BY )1� WHO IS PERSONALLY KNOWN TOME ❑tI OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTARY P LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER �uuu KAREN S. NIELSEN
tpAY PGe�.
0, State of Florida-N Public
=* *_ Commission # GiM484
My Commission Expires
OF FL . June 12, 2022
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SLCPDSD Revised 04/11/2011