HomeMy WebLinkAboutFilled Land Affidavit -; �:.- PLANNING&DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Divisio�
2300 VIRO NU AVENUE
FORT PIERCE,FL 34992-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned,am the owner of the following described property,
(Parcel I&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 pe 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 for 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 advers ly affect the immediate
community.
JOs.CpN /tlicuA-Ll r-W&r-201
Property Owner Name(Please Print)
3 / /7
f'ro er igna Date
STATE OF FLORIDA,COUNTY OF
Awlq
ACKNOWLEDGED BE OREnM,EE THIS 1 DAY OF 20
B GrK/ /llt ----IS PERSONALLY KNOWN TO
NM(_)OR WHO HAS
P DUCED I AS IDENTIFICATION.
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/SIIGI OF NOTARY P BLIC TYPE ORPRINT NOT
COMMISSIONNUMBER
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6 My Commission GG 092440
?�po� Expires0712712021
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SLCPDSD Revised 04/1 V2011
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