HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
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,
5 3 aU SOCL FSIMLCUM FL
(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.
W. Bryan Adams
,2;;0wner Name Please Print)
Property Owner Signature
Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS ;— DAY OF 0 —VyL 20 19 1
BY W. Bryan Adams
PRODUCED
r�1G 00j- wa um
`SIGNATURE OF NOTARY PUBLIC
017099
SLCPDSD Revised 04/11/2011
COMMISSION NUMBER
WHO IS PERSONALLY KNOWN TO ME CIZI) OR WHO HAS
AS IDENTIFICATION.
Hannah Moore
TYPE OR PRINT NOTARY
(SEAL)
VV
:per °w� Notary Public Slate of Flwide
Hannah E Moore
• My Commission HH 017099
5�a 'd Expires 07/012024