HomeMy WebLinkAboutFilled Land Affidavit - PLANNING& DEVELOPMENT SERVICES DEPARTMENT
- Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
R E C E I V E D Olt t 0� 7317 FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
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'NZ5- 703-0034-000-to 91*t&t40(P667-3(-)zo73/ 13321 N01 §)No0o PL PQLHCH-1
(Parcel Id#/Legal description/Address) 3yggo
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 Qwner (Please Print)
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P caner Signature Date
STATE OF FLORIDA,COUNTY OF M A,RV 4
ACKNOWLEDGED BEFORE ME THIS 2 Z DAY OF M A kC,4 ,20 17
BY 9US.5&tL ftAtZ0I WHO IS PERSONALLY KNOWN TO ME L_)OR WHO HAS
PRODUCED Ft DL &&3 . 1/67"0 AS IDENTIFICATION.
SIGNATURE OF NOTARYABLIC TYPE OR P :.;
MY COMMISSION#FF928213
EXPIRES:January 3,2020
COMMISSION NUMBER Bonded Thru Notary Public Underwriters
Rf;�h•`•
(SEAL)
SLCPDSD Revised /1 04 1/2011
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