HomeMy WebLinkAboutFilled Land Affidavit I
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
COUNTY
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,
I5s 5E �jlJ�iO �VIeT �T Si.6t�618
(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 P5371 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 Name(Please Prin
I
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF IV �,�
ACKNOWLEDGED BEFORE METHIS DAY OF 20 O��1 ,
BY iln n `� WHO IS PERSONALLY KNOWN TO ME ❑U OR WHO HAS
PRODUCED AS IDENTIFICATION.
UI
SIG TURE OF NQjARY PUBLIC TYPE OR RIN N ARY
CZ
O OMMISSION NUMBER
(SEAL)
�<PPV PUB,, ELLEN VAUGHN
State of Florida-Notary Public
SLCPDSD Revised 04/102011 Commission # GG 270079
N� OF F�°QA My Commission Expires
" "` October 22, 2022