HomeMy WebLinkAboutFilled land affidavit From- ` 04/07 7 77=07 #087 P_002
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_ PLANNING&DEVELOPMENT SERVICES DEPARTMENT
" Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
#1 0 — 01-3
7 9
I,the undersigned, am the owner of the following described property,
3211 — 701 — OW4— 000/I CA2.t_TO•J cav"T!V CST/01'6S LoT
(Parcel!d#/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 i704 —0139 , 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)
Prop a Date
STATE OF FLORIDA,COUNTY OF W
ACKNOWLEDGED BEFORE ME THIS DAY OF ,20f_,
BY A z _0ir\tw fl) G�—WHO 1S PERSONALLY KNOWN TOME(__)OR WHO HAS
PRODUCED AS IDENTIFICATION.
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��SaNA
e� SI QN RE OF, ARY LIC TYPE OR PRINT NOTARY
\ COMMISSION NUMBER
��4` �-''L' Jason Hendr
COMMISSION # Ff19S
` EXPIRES:FeDrm 23,2M9 j
SLCPDSD Revised 04/11/2011 o .�` WWW.AARaNNOTARY.COM
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