HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT:-`
Building & Code Regulations Division
2300 VIRGINIA AVENUE
NO FORT PIERCE, FL 34982-5652.
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned,, am the owner of the following described property,
q'- N5 — 4 61y6' O a m --
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.
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Prop Own NVine (Please Print)
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Property Owner Spnatule Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF a Alp 20 .
By j � 1-OLxA Q�S WHO IS PERSONALLY KNOWN TO ME Q OR WHO HAS
PPPUCEDl_ AS IDENTIFICATION.
SIG ATURE OF NOTARY P43LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
LASHAHNAINGRAM
Notary Public - State of Florida
SLCPDSD Revised 04/11/2011 n My Comm. Expires Dec 20, 2018
Commission # FF 177249
" ,an",aal Notary Assn.