HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34952-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
13ol • Lco---+• 03cw ..cam- S 'Z(j�olj PeK2a:r L-C-r-,-a j
(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, • Q� 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.
ffiQrf )� 4)f,
Property Owned Name (Pldas6 Print
,Pro . e Sigtiature D e
STATE OF FLORIDA, COUNTY OF _
ACKNOWLEDGED BEFORE ME THIS WAX-) . DAY OF
BY 4 rj WHO IS PE TO ME (a) OR WHO HAS
PRODUCED
SIGNATURE �CNOF/NOTARY PUBLIC v TYPE OR PRINT NOTARY
=%COMMISSION NLMBER
(SEAL)
AS IDENTIFICATION.
SLCPDSD Rcviscd 04/1 1/201 1 NOWV pubk goo of flolire
HaMher C DaW
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,
7woq Penny LanG
1301 • 4p0'1 •0 3C V • O0c�'S t.A wewoad Pb tl` PKIC
(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.
(Please Print) -
Signature
STATE OF FLORIDA, COUNTY OF
8-lq. 2o-W
Date
AC KN EDGED EFO ME THIS DAY OF kk 20AOa
BY WHO IS PERSONALLY OWN TO ME C�R WHO HAS
N