HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
` - Building & Code Regulations Division RECEIVED
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 APR - 5 2021
(772)462-1553
- Permitting Department
St. Lucie County
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
C/ 6ro5- - Coo -
(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.
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Property Owne a(Please Print
77
L — 1
Owner Signature- Date
STATE OF FLORIDA,COUNTY OF�� A,(V�w
ACKNOWLEDGED BEFORE ME THIS _DAY OF CA\1 20a
BY � � r V� _ C.� WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIG ATURE_ OF QTARY PUBLIC TYPE OR P TARY
COMMISSION NUMBER
(SEAL)
�f rw Notary Public State of Florida
SLCPDSD Revised 04/11/2011 ,P `f; Danyel Jones
o` My Commission GG 352016
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