HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGR41A AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
o�So 3 YN6A
(Parcel IM/Legal description/.
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 Name (Please )
Plperty Owner Si a Date
STATE OF FLORIDA, COUNTY OF $? - (- w C / t
ACKNOWLEDGED BEFORE ME THIS 16 _ DAY OF _ AI o t/ �y� 'J r'" , 20 A D ,
BY N /0 6t-- - &L A L/ WHO IS PERSONALLY KNOWN TO ME CO) OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOT PUBLIC TYPE OR PRINT NOTARY
vW COMMISSION NUMBER
(SEAL)
"'' WILLIAM H DONOVAN JR
MY COMMISSION # GG093576
EXPIRES April 12, 2021
SLCPDSD Revised 04/11/2011 ?'�bii',.•'•
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