HomeMy WebLinkAboutFILLEDLAND9 " II Bill "6 PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGIMA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
Iq" 311-6035-0oph
(Parcel Id#/Legal description/)
+ncA Trai
-)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
that as owner of the above described roe I acknowledge
c'e with Section
7.04.01(D), St. Lucie County Land Development ode, Ishall be responsible or 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 propertm
y,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any for,
adequate drainage off my property which will not adversely affect the immediate
community.
Property Owner Name (Please Pri
Pro rty Owner lgnature )
Date
STATE OF FLORIDA, COUNTY OF :5� W CV _
ACKNOWLEDGED BEFORE ME THIS __ `y DAY OF __ b
BY t r) 20_0>
WHO IS PERSONALLY KNOWN TO ME (®) OR WHO HAS
PRODUCED T�
AS IDENTIFICATION.
COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
iv v 1 t1iC T
(SEAL)
Rop
11 Y State FlorWa
Christine-e A. A. MarshonHMy COMMISS H 026766
Expires 08/02/2024
F'