HomeMy WebLinkAboutFilled Land Affidavit ST.J[.UCI E COUNTY
`.1 BUILDING & ZONING SAY 0 Alf
2300 VIRGhNIA AVENUE
— FORT PIERCE,FL 349$2-5652 6�ER-.4iTTIiUC
SL Lucie C;OUnty, FL
772-462-1553
FILLED LANDS .FEIDAVIT
1, the undersigned, am the ovmer of the following described property- , ,--.
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(Tax 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'Mth 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 obli;ed
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 Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF S L N C t e
ACKNOWt- ��(
LEDGER BEFORE iY1ETHIS�I DAY OF C i ZOLr
BY i I U • i t WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
F L l.- AS IDENTIFICATION. .
SIGNATURE QF NOTARY TYPE OR PRINT NANfE OF NOTARY
NOTARY PURLTC TII L E Frb f'35e`C (SEAL)
OhIi4llSSION NUMBER
` Y,:,w(,cw 7AINANDA PINKSTON-CMpto)
:. Notary Pubfic-Srite bYFiorlda
MYCnmm.Exyires May 1.2017
Commission 0 Ff 013587