HomeMy WebLinkAboutFilled Land Affidavit i
M PLANNING &DEVELOPMENT SERVICES DEPARTMENT
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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,
53y55 Gol.ey way
VID - 50.E-009-7 DeWl? RF-01-75 Coop
(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.
Y-0 tv
Pro erty Owner Name(Please Print)
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Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF J4 1 a I LV G 1`.e
ACKNOWLEDGED BEFORE ME THIS l7 DAY OF U 120 f
BY ' 11 n F h 0 C �/)1/V _WHO IS PERSONALLY KNOWN TO ME Lam)OR WHO HAS
0/f rp,
PRODUCED, AS IDENTIFICATION.
N ARY PUBLIC
TYPE OR PRINT NOTARY u ��r TQ A
SIGNA E OF OT
COMMISSION NUMBER
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RY ANN MA 1
OMMISSION#FF95313a
PIRES January 24.2020FI[xihaNq; vScrvrcc:o i
SLCPDSD Revised 04/11/2011
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