HomeMy WebLinkAboutlandfill affidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
i 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,
4426-804-0015-000-6 Harbour Ridge plat9 Lancewood village unit 5 1316 NW Lancewood Ter Palm City FI 34990
(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.
t6s ,
Property Owner ame (Please Print)
Property Owner Si ature Date- t
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS Q (n DAY OF f _, 20C� �_,
BY WHO IS PERSONALLY KNOWN TO ME t) OR WHO HAS
PRqPUCED �� AS IDENTIFICATION.
ARIMPUBLIC
GZ'5a51 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
,S�i rl TYPE OR PRINT O �l��e�
(SEAL)
SHIRLEY LIrTLEFIELD
Notary Public - State of Flo]2023.
Commission d GG 34525My Comm. Expires Jun 13.ded through National Notary