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 followingdescribed property,
P P Y,
901d Sduitl.. OceAoj )NI tP -�'e,vspro Beojc� Fl- 341-9'$-;�
(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.
Property Owner Name(Please Print
Property Owner Signature Date
N4wy,C
STATE OF FAA,COUNTY OFF �.
ACKNOWLEDGED BEFORE ME THIS /V L DAY OF r/�,t/�I'Gf` ,20 f
BY E Zi�L l WHO IS PERSONALLY KNOWN TO ME L—)OR WHO HAS
PRODUCED 4n. 4-! r
AS IDENTIFICATION.
4�NTOT;fARYPT
SIGNATUREOBLIC TYPE OR PRINT NOTARY
COMNIISSION NUMBER
MICHAEL R6E,"KGG1wS CREED
Notary Public- State of New York
N0. 01 CR6254579
Qualified in New York County
SLCPDSD Revised 04/11/2011 My Commission Expires Jan 17,2020