HomeMy WebLinkAboutFilled Land Affidavit 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,
5211 o�1 � n Green AID �I e�L-e 3� 951
(Parcel Id#/Legal descripti 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.
tauven A SZemorc
r Own Na Mlee n
Pr erty Owne S gnature Date
STATE OF FLORIDA,COUNTY OF L`AJ6
AC OWLEDGED BEFORE ME THIS DAY OF 20
BY S PERSONALLY KNOWN TOME ❑U OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTrRfPTUIC TYPE OR PRINT NOTARY
MMISSION NUMBER
(SEAL)
O
0 „tw{.HYn pGe
s ELLEN VgUG
`* Ite Of Florida-Notary public
MI Sion #
SLCPDSD Revised04/11/2011 /�� o` My CommissionG 270079
October 22 20llires
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