HomeMy WebLinkAboutFilled Land Affidavit I
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 j
FILLED LAND AFFIDAVIT
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I,the undersigned, am the owner of the following described property,
a7 6r-oe.1CS-k"tj-A ED Z';ks�Lo 50) 001'5? Oob/6
(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 1
community.
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Prop Owner ame lease Print)
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rope Owner S gn Date
STATE OF FLORIDA,COUNTY OF S t4 Cl e
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ACKNOWLEDGED BEFORE ME THIS�DAY OF r J p I-) I r '7
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BY ( ndGL /nI-& ff4rj WHO IS PERSONALLY KNOWN TOME&OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGN URE OF NOTARY UBLIC TYPE OR PRINT NOTARY �_
C COMMISSION NUMBER
(SEMSICA LYNN JONES
_ Notary Public-State of Florida
oc Commission#GG 038637
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;;ovc�Qa•• My Comm.Expires Oct 15,2020
SLCPDSD Revised 04/11/2011
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