HomeMy WebLinkAboutSMITH FILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
- Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE. FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner of the following described property,
• /3 • D 405 • a 44 • 9S T o�,�s ,�G
(Parcel ld#/Legal description/Address) FT Al ewee. ie- 3995�5
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.
Property ner Nhhe (Please Print)
Property Owner Signature Date
STATE OF FLORIDA_ COUNTY OF —
ACKNOWLEDGED BEFORE MET[IIS DAY OFs� 20v��
Or
By i�j�/l� i /Uf' WI lO IS PERSOOYN�ALLLY7 KNOWN TO MF (0) OR WHO HAS
PROS FD/e� �S.S.�D •��jl%�/oS ' /�7' • 9!�' AS IDENTIFICATION.
SIGNA- tE OF NOTARY PUBLIC C1 TYPE OR PRINT NOTARY
OMMISSION NUMBER
SLCPDSD Revised 04111/2011
1SEA
91V Pr. No=11,2812)22
f Florida
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