HomeMy WebLinkAboutFilled Land AffdavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
e Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3402-606-0208-000-1 and 4915 silver oak DR Fort Pierce FL 34982
(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.
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF ST. Lucie
ACKNOWLEDGED BEFORE ME THIS � DAY OF V�LY`y 120
NO
BY ay l a 1 V �CV424) q--�J2, WHO IS PERSONALLY KNOWN TOME M OR WHO HAS
PRODUCED
SIGNA1XJRE 1O'F NCQI� PUBLIC
f 3 `f COOMMISSION NUMBER
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
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TYPE OR PRINT NOTAR
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KELLIE SHAY BEEBE
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Commission # GG 94999AL)
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Expires January 21, 2024
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Bonded Thru Budget Notary Services