HomeMy WebLinkAboutFilled Land AffidavitPLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FE 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT .
I; the undersi ned, am the owner f the following described prope
8obu. v� 3o�P2 ' �l si
tJJ i nMru�l� U, u-4" &V-a 00 1, Lim B 4 .,"AW I&A-5 14
(Parcel I&ILegal 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.
Property Name (Pi se Print)
Property Owner ignature Date
STATE OF FLORIDA, COUNTY OF e
ACKNOWLEDGED BEFORE ME THIS 1 I * DAY OF �Q C_ 20_ ,
BY I h eJDd0re- WHO IS PERSONALLY KNOWN TO ME Lk ) OR WHO HAS
PRODUCED
U �
SIGNATURE OF NOTARY PUBLIC
AS IDENTIFICATION.
C.Un�i11a I� IUrn.�-�
TYPE ORIPRINT NOTARY
Htof quo COMVJISSION"'I
NOTARY PUBLIC -STATE OF FLORIDA
Cynthia D. Turner (SEAL)
Commission # EE101960
`-: �?.•� Expires: JUN.16, 2015
BONDED THRU ATLeLN HC BONDING CO., INC.
SLCPDSD Revised 04/11/2011