HomeMy WebLinkAboutFilled Land Affidavit -'1 Y ,,•��^-�'''1'. �Fri r:
c` MAY 0 3 201
St. Lucie Count)-, FL
PLANNING&DEVELOPMENT SERVICES DEPARTMENT
BUILDING&CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I,the undersigned, am the owner of the following described property,
002 501 oS15 coo$ 38 7Hrr7'1.Es 341/70 FL
(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.
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Property weer N ne(Please Print)
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Pr8p'6rq Owner Si'aturd Date
STATE OF FLORIDA,COUNTY OF L _ ' lit u �P_
ACKNOWLEDGED BEFORE ME THIS DAY OF �(^t I 20—T1
BY tlft,nJ e- I �O IS PERSONALLY KNOWN TO ME '� OR WHO HAS
PRODUCED AS IDENTIFICATION.
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�TGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(sE,WLA NELSON
Notary Public-State of Florida
Commission M FF 965535
M Comm.Expires'Feb 25,2020
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SLCPDSD Revised 08/24/2010