HomeMy WebLinkAboutFilled Land Affidavit 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,
- I of 0 NS� - 4100 -'t
(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.
Pro rty Owner Name(Please Print) \J zll(q 7
P ii Owner Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS C DAY OF Ln\\\1 120
BY •j-'Nq\ LaJ/N WHO IS PERSONALLY KNOWN TOME C__)OR WHO HAS
PRODUCED l` AS IDENTIFICATION.
�,
IIAT (O BLIC TYPE O PRINT NOTARY
G3'O-1 �C\COMMISSION NUMBER
s �TUEL NAPOLES
. (
• MY COMMISSION#GG072039
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'± dEXPIRES February 12,2021
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SLCPDSD Revised 04/11/2011
RECEIVED
APR 0 4 2017