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HomeMy WebLinkAboutFilled Land AffidavitPLANNING & 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, (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 rj D 1 1 •© 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 hi 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. no a-e� 1Do wl(--, war+ +:I- u Property Omqi& Narne ( ease Print) Pro ' . er Signature DP e STATE OF FLORIDA, COUNTY OF [�, (-E' f[�f rL�► ACKNOWLEDGED BEFORE ME THIS J. D'14 .DAY OF N X L%P�d 1 1�/� .20 I b BY }�i� (.f� P/.\ (�] �.L. WHO IS PERSONALLY KNOWN TO ME (0) OR WHO HAS PRODUCED AS IDENTIFICATION. SIGNATURE OF N0- T R PUBLIC TYPE OR PRINT NOTARY OCOMMISSION NUMBER (SEAL) SLCPDSD Rcviscd 04I1 U201 I%rl%w NOWgWO of Ftondes Cornrni�san HH 02000 a Uwa O WMA 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, Iso l J to nrneca; R 0CL4 13 a i - to-"- ooz6 000-u i a ic mooad RzlC o?i;f 3 BI 1vij L.ot w (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. Print) Owner Signature 8-rg• Date STATE OF FLORIDA, COUNTY OFa�[CL�A ACKNOnIEDEFOR ET H. DAY OF 20, BY WHO IS PERSONALLY OWN TO ME (�) OR WHO HAS PRO UCED AS ID1ENTIFICATION. masw SI N URE OF ROT A& I IC �. �`�'� TYPE O T NOTARY no SION NUMBER -L r (SEAL) �00 x�4 Notary Public State of Florida Brittany L Rubino y� My Commission GG 271879 SLCPDSD Rcviscd 04/11/2011 �tawd� Expires 10/28/2022