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
RECEIVED My 0 5 20'9
I,the undersigned, am the owner of the following described property,
/vokTN Foiz K Es7-AT�5 S/D /-o-r a l (v,ser4e-' CoA /5',,l-/7oa
3gar-- 5D3-000q- 000 - A,:zJ ,��LyAA6 (FT-
(Parcel I0ILegal description/Address) 77 P)E-Xe-,E-)FL
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(P a Print)
Property Owner Sign tune Date
STATE OF FLORIDA,COUNTY OFF/" LI `
ACKNOWLEDGED BEFORE ME THIS DAY OF 1 20 ,
BY _RPpJ— WHO IS PERSONALLY KNOWN TO ME(�OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIG A/1 O NOTARY P IC TYPE O RINT NOTARY
J /T� COMMISSION NUMBER
40&W°ei (Slti6116d Public State of Florida
Kaylin J May
r � My Commission FF 914312
av 00 Expires 1 0/0 31201 9
SLCPDSD Revised 04/11/2011