HomeMy WebLinkAboutFilled Land Aff PLANNING&DEVELOPMENT SERVICES,DEPART RECEIVED
' Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 FEB 082018
(772)462-1553
ST. I_uSio GQwnty, Permitting
FILLED LAND AFFIDAVIT
1,the undersigned, am the owner ofthe.following described property,
(Parcel Id#/L'egal description/Address)
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for which I have applied to 'St. Lucie-County for a�Final Develapment 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.'
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Property Owner Nam Ole rint)
Prop rty Owner Signature Date
STATE OF FLORIDA,COUNTY OF
117
ACKNOWLEDGED ME THIS '✓ V DAY OF T Uy(�J 20 ,
BY lrPSf d�� � WHO-IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
�h 7(3 COMMISSION NUMBER .w
(SCAMERINE PICHE
MY COMMISSION*GG 046763
EXPIRES.Nmmber 8,2020
: I3W4*d7hu NaWyPubte llndwwMm
SLCPDSD Revised04/1112011'� ,
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