HomeMy WebLinkAboutFilled Land Affidavit P LANNIIN(G & ➢DIEV EIL®PMi IEN7 SIEII WES DIEPAI[87PViIIEN7
cC tt�iJ r'� Building&Code Regulations Division
r ik 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
IFIIILIL]EllD LAND AIF'IF HDAVIT
I,the undersigned, am the owner of the following described property,
(Pared 1 d#/ILc pR dezcrgpiflon/Addrl m)
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 sand Development(Code,I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
1 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 lease Printr-7� )
-� � � 7 �� 7
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF Ivl AV-
ACKNOWLEDGED BEFORE ME THIS 7 DAY OF 220 ,
BY �. / -TA WHO IS PERSONALLY KNOT 1N TO ME OR WHO HAS
PROD ED AS IDENTIFICATION.
C�IUNA E OF NOTARY PUBLIC TYPE OR PRINT NOT..ARY
COMMISSION NUMBER
(SEAL)
e�weg�U0loNloBpngn�y�PapacB ��,a�'I�j011br�
80Z'U hV4 c53dIdX3
SLCPDSD Revised 04/11/2011 499Z10 dd#NOISSIWWOO I W
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