HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL34982-5652
(772) 462-1553
FILLED LANDS AFFIDAVIT
Ithe ersigned, am the owner of the follow ng described property,
,I
—40 o t - DO / & -c� oo - Z./23G4 -3rD4e-
(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.
Property Owner Name (Plea a Print)
8 2 2 7A
Proper Owner Signature Date
STATE OF FLORIDA, COUNTY 0 LL��—
ACKNOWLEDGED BEFORE ME THIS DAY OF CIL 20�Z^.
Bye WHO IS PERSONALLY KNOWN TO MV_ OR WHO HAS
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
COMMISSION NUMBER =ocog; P�e�,c SHERRI FEHLMAN
(SEAS,) * Commission # GG 187160
N9r = Expires March 14, 2022
;OF FT';\oBonded Tixu Budget Notary Services
SLCPDSD Revised 08/24/2010