HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
MUS 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
Re -f V_
(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.
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Property er Name(Please PrM )
,Qgo W&u aood — — ) .-;2
oper weer Signature D to
STATE OF FLORIDA,COUNTY OFO�A
ACKNOWLEDGED BEFORE ME THIS S DAY OF 20 I >
BY a P-0 r-X—C 0 IS PERS LLY KNOWN TO ME ID OR WHO HAS
PROD AS IDENTIFICATION.
SIGNATURE OF NOT PUBL C YPE OR P T NOTARY
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COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/201 I AUDREY R.HUMPHREY
g*:�= MY COMMISSION t1 GG 300817
EXPIRES:March 6.2023
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