HomeMy WebLinkAboutFilled Land Affidavit 4 F.M.—M. PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 RECEWED
(772)462-1553
FEB 16 2017
FILLED LAND AFFIDAVIT PERMITTING
S'. Lucie County, FL
I,the undersigned, am the owner of the followingdescribed ro erty,
2. y47rjl p�3
PI'ap. &ell//S p12 j
(Parcel ld#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Nulr<* /7 02,— O 5 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 O er ame(Please Print)
r � 664 ;x- 1L
Propey'tyO e Signature Da e.
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS, LR DAY OF 120 01
BY \P�I�1�N { I�l.�l�1-T1T'�A�WHO IS PERSONALLY KNOWN TO ME L--)OR WHO HAS
PRODUCED —`l- AS IDENTIFICATION.
SIGNATURE OF N TARY PUBLIC TYPE OR PRINT NOTArY
COMMISSION NUMBER
KAREN S. NIELSEN EAL)
�= Commission # FF 115637
My Commission Expires
June 12, 2018
SLCPDSD Revised 04/11/2011