HomeMy WebLinkAboutFilled Land Affidavit .. I
i PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE,FL 34982-5652
(772)462-1553
JUN 2 9 2018
FILLED LAND AFFIDAVIT ST. Lucie County, Permitung
I,the undersigned, am the owner of the.following described property,
C:?13io } poi - 0o1(0 -- 000 - 0),
(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 Name(Please Print)
Prope er Signature Date
STATE OF FLORIDA,COUNTY OF 4. W I�
r I
ACKNOWLE GED BEFORE ME THIS_ _DAY OF L l 1J .204—
BY � WHO IS PERSONALLY KNOWN TO ME(El OR WHO HAS
PRODUCED ` AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
KAREN S. N1Fs N
?=we,-State of Florida-(Votary ublic
Commission #GG 207484
?,� My Commission Expires
��� June 12, 2022
SLCPDSD Revised 04/11/20I I
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