HomeMy WebLinkAboutFilled Land Affidavit 15
RECEI�'T: MAR 21 ���7 J
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PLANNING&DEVELOPMENT SERVICES DEPARTMENT
BUILDING&CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I,the undersigned, am the owner of the following described property,
231t)-660-0157-00078 9tLm 394ZtE-K CZu& &0 33811Z%9ua
(Parcel td#/Legal description/Address)
for which 1 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.
WILLIPM fit• STlLtfs SP,
Pro 0 er Name as rint
03 AD I.'�
roperty Owner& ature Date
STATE OF FLORIDA,COUNTY OF ���►�'
ACKNOWLEDGED BEFORE ME THIS C(] DAY OF 1 ' O
BY �����1\1 2r-O A eS ✓Y 'WHO IS PERSONALLY O ME OR WHO HAS
PRODUCED AS IDENTIFICATION.
��_ �QG.� ��� er►� S . i�c.Ja_1 I�.c-�
SIGNA'rURE OF NOTAkY PUBLIC TYPE OR PRINT NOTARY
CI CI 0�311°1 COMMISSION NUMBER
(SEAL)
•' ;^ BEVERLY S WALLACE
s .
' MY COMMISSION#00023777
SLCPDSD Revised 08/24/2010 �� EXPIRES Novarnbar 03,2020