HomeMy WebLinkAboutFilled Land Affidavit PLANNING&DEVELOPMENT SERVICES DEPARTMENT J �4C4Fp,,
� Building&Code 23oo vutGirllaAat ions Division
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FORT PIERCE FL 34982-5652 St
(772)462-1553 �41%Caart
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FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
1 W a S,701 -0075"-yo0 6 i CoR►9! Cove geac� —s6 Tj' o e -
(Parcel Id#/Legal description/Address) U LK 4 Lo7 f
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number ` `l , 00 I acknowledge
that as owner of the above described property, and in ac ordance 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 finther 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:
Ale'VAAAO' 005A
operty Owner Name(Please Print)
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF � C[rP
ACKNOWLEDGED BEFORE ME THIS DAY OF� ,20
BY k1 O IS PERSONALLY KNOWN TO ME CID)OR WHO HAS
PRODUCED AS IDENTIFICATION.
C"Niwk"
o
SIGNATURE OF NOTARY P LIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
ELLEN VAUGHN
-o`" s State of Florida-Notary Public
SLCPDSD Revised 04/11/2011 =_
=• •_ Commission # GG 270079
?9 7 My Commission Expires
� 0ii���`° October 22, 2022