HomeMy WebLinkAboutFilled Land AffidavitPLANWINI G & ' ` __ VELOPMEN k SER4WES DEPARV0>r T
R _ _ 1ng & Code Regulations Division
2300 VIRGINLA AVENUE
FOOT PLERCE, FL 34982-5652
(772) 4t52-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
Y1 7—/ — M& - "M
(Parcel it'i Legal description/Addrew)
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 MMIL 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 (Please Print)
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Property Owner Signature Dane
STATE OF OF
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ACKNOWLBDGM BEFORE METHIS _DAY OF o�/�e7- 20 l
BY Q� %� r A0 IS PERSONALLY Ki+St %,N TO Nm OR V1HO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC TYPE ORPRINT NOTARY
COMMISSION NUMBER
(SEAL.)
RANDI AIZr25,2021
Notary Public — Stat
County of Ma
My Commisslori ExpirSLCPI3SD Revised04/1 t/2011Acting in the County o
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