HomeMy WebLinkAboutFilled Land Affdavit WimmermanPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
• R I • A 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
( 772-) 462-1553
F11.LED 11AND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
4504-602-0005-000-2
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Finial 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 1n any form,
adequate drainage off my property which will not adversely affect the immediate
community.
Property Owner Name (Please Pritn)
117
Property Owner Signature Dater
STATE OF FLORIDA, COUNITY 0.F �� �"
At'KN0W1.,F~I)(Yi.;,l) BF.FnR ETHIS i E DAY (�1= ZL . 10
6Y�l ' W! I'10 IS PERSONALLY KNOWN TO MF ) OR WI-10 I IAS
PRODUC UD
r _
I�
5IGNATURF OF NOT.. PUBLIC: TYPE OR PRINT NOT.kR.Y
COMMISSION NUMBER
,,,.•r•P •,
(SEAL)
DIANE COLE
Forlda
•
Notary Public o f
- 1089
96
• . <: Comm Z4
;a• tee: Expires Near 14, 10
•� rK f�°�' MY Comm. E ar Assn
SL("FllSU Rr.��isc:d 04,11 i�U 11 '•• ......•••gunded throuth National Not Y •
AS I1)FN'1 IFICATION.