HomeMy WebLinkAboutFilled Land Affidavit PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGMA AVENUE
FORT PIERCE,FL 34982-5652 RE C"R I V D
(772)462-1553
NOV 02.2017
FILLED LAND AFFIDAVIT PERMITTING
St. Lucie County, FL
I,the undersigned, am the owner of the following described property,
77 80 3 '-�Ajv)F ' ST z!�T
(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.
Pro erty er Name(Please Print)
Przg ` IZ1�1
rope weer Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEF ME THIS 2— DAY OF Q 20
�V
BY �,�p%JR_WHO IS PERSONALLY KNOWN TO ME CO)OR WHO HAS
PRODUCED • AS IDENTIFICATION.
SIG ATURE OF T PUB IC TYPE OR PRINT NOTARY
""""'• KAREN S. NIELSE-N
Commission# FF 115637 (SEAL)
_. .:
;, o? My Commission Expires
�':'fo..���•°� June 12, 2018
SLCPDSD Revised 04/11/2011
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