HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
ISTLUCM
COUNTY Building& Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
ooL15g -WD- 5
(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.
Mato L J-P on �r
Property Owner Name(Please Print)
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OFF_I V
ACKNOWLEDGED BEFORE ME THIS r DAY OF r14Z� 20��,
BY WHO IS PERSONALLY KNOWN TO FvIE cup OR WHO HAS
PROD CE 0 42 1 1;�1 AS IDENTIFICATION.
j W—k �k D
SIGNATURE OF P LIC TYPE O T NOTARY
CpG6 40—COMNUSSION NUMBER
=�tl�'U� JACK HEBERT
MY COMMISSION#GG914867
EXPIRES:September 19,2023
SLCPDSD Revised04/11/2011
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