HomeMy WebLinkAboutFilled Land Affidavit PLANNING& DEVELOPMENT SERVICES DEPARTMENT
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,
qZy LA up
eL-5 ?LAc.E '?U/--r -5e7 Luc.rt k- 3gyV(0
(Parcel IM/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 m property which will not adversely affect the immediate
�l g Y P Pe Y Y
community.
Y
r2->G -ro
Property Owner Name(Please Print)
e-- 51 Z6- /�
Property Owner Sign a Date
STATE OF FLORIDA,COUNTY OF MA47/,v
ACKNOWLEDGED BEFORE ME THIS Z(40 DAY OF M A 20
BYQ L.7 13uiC701/ WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
e710 PRODUCED ��- 4/L 15'--7r0 3:5Y-``GV-U AS IDENTIFICATION.
S TURE OF ARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER .;;i� JULIE M SCALlBE
;.R' 'Iti
MY COMMISlQM#GG091020
"V�7a.Y.- EXPIRES Aptil 08,2021
SLCPDSD Revised 04/11/2011