HomeMy WebLinkAboutFilled Land Affidavit - PLANNING & DEVELOPMENT SERVICES DEPARTMENT
o- Building& Code Regulations Division
2300 VIRGINIA AVENUE �
FORT PIERCE,FL 34982-5652 4y _t,'L
(772)462-1553
MAC 2 8 2017
FILLED LAND AFFIDAVIT PERfi iITTING
St.Lucie County, ►=L
I,the undersigned, am the owner of the following described property,
PiveeM,),J J BkLdibl ?51 /� uiaqt
(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.
01i Y_IQVO,�
Pr Owner Name(Please Print)
3•l5• i`7
rig erty Owner Si^ ture Date
STATE OF FLORIDA,COUNTY OF !�&. LLWA-
ACKNOWLEDGED BEFORE ME THIS _DAY OF / p 16_ l% - 201!
BY �ffiWHO IS PERSONALLY KNOWN TOME C__)OR WHO HAS
PR U ED lr 0 AS IDENTIFICATION.
aAjow&z
IGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBE
+`9 fK-, FARA D HERNANDEZ
_ >l MY COMM#§&W#FF172419
J+`` �f' EXPIRES October 28,2018
OF
(•107)398-0153 FlorldawaryService.com
SLCPDSD Revised 04/11/2011