HomeMy WebLinkAboutFilled Land Affidavit �J
PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
_ - 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 _ [!. FF
FILLED LAND AFFIDAVIT
MAR ? 3 201
PERr0ITTING
St. Lucie COUTItV.
I,the undersigned
d am`t owner 3of/hae following vz described propert
G 3077 -/?
or �
(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.
Property Owner (Please P 'nt)
P ope Owner Signa re Date
STATE OF FLORIDA,COUNTY OFS/, I U619
ACKNOWLEDGED BE ORE ME THIS2 DAY OF
BY WHO IS PERSONALLY KNOWN TOME C—)OR WHO HAS
PRODUCED' L AS IDENTIFICATION.
�IGNAATUREOF NOT AR PUBLIC TYPE OR PRIN N�T OTARY
COMMISSION NUMBER
YyB tc'i
KAREN S. NIELSEN
xr - Commission;t Ff( 37
°• " My Commission Expires
3, June 1^ 2018
i�fF OF f`4 �,
�IIIIIIF�``
SLCPDSD Revised 04/11/2011