HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGMA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3y 33 j Odnl doolr
(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.
Pr er Name (Please Print)
YA L6&A. a�4)�o
cr�ala�
Properfy Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME TIES 4— V 6 DAY OF V "L 20 a
BY % IOW LCX- WHO IS PERSONALLY KNOWN TO ME (EE5'OR WHO HAS
PRODUCED
AS IDENTIFICATION.
SIGNAIfURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
6193aa 6DBpCOMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/201 L f' CYNTHIA BAKER
Ml' COMMISSION�832023
d°F EXPIRES: August
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