HomeMy WebLinkAboutFilled Land Affidavit 0
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGWIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
��T6 P0& s 5, /5"5 (_ ��-
(Parcel Id#!Legal description/ ddress)
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.
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@QrNyoAw�njer Name(Please Print)
Property Owner 0 Date
STATE OF FLORIDA,COUNTY OF S- L.Ac''--
ACKNOWLEDGED BEFORE ME THIS i `? DAY OF �e_G&Yt bedf
BY!ee, .xS - LoG U�i d i C� _�WHO IS PERSONALLY KNOWN TOME( OR WHO HAS
PRODUCED D L 1-1-3 Z - 17 O ID ' ` 9ZZ— 0 AS IDENTIFICATION.
SIGNATURE OF NO 'ARY PUBLIC P,,F�1T IOT '
otary ublic-State of Florida_
COMMISSION NUMBER =' Commission GG 032801
My Comm.Expires Sep 22;2020
�F�0'� Bondedthr j ' nalNotary�ssn
SLCPDSD Revised 0411 1120 11