HomeMy WebLinkAboutFilled Land Affidavit RECEN ED MR'( 0 4.Z011
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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,
.3(/a - 51).7 - a"/ e /7® - a
(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 Owner Name(Please Print)
Ll 1Z 11
Property Owner Signature Dat
STATE OF FLORIDA,COUNTY OF��
AC NOWLEDGED BEFORE ME THIS D DAY OF 4 r` ,20�,
BY — &_1 Cat ( d'4SHO1S PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED f� AS IDENTIFICATION.
'Z—!��;�rUREOF NOT PUBLIC TYPE OR I'RIIV NOTARY
COMMISSION NUMBER
SHERRI FERMAN (SEAL)
MY COMMISSION#FF i00370
, �4
EXPIRES:March 14,2018
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SLCPDSD Revised 08/24/2010