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 F3 10 ,� an bz n i datto 'PL (I I H I S�
(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
7 Owner Name Please Print)
Lo I31a1
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS DAY OF � Nltl—" , 20 @ 1
BY W. Bryan Adams
WHO IS PERSONALLY KNOWN TO ME C[Ej) OR WHO HAS
PRODUCED
`ft —Wullx� �UOAJ
SIGNATURE OF NOTARY PUBLIC
017099 COMMISSION NUMBER
SLCPDSD Revised 04/11/201 I
AS IDENTIFICATION.
Hannah Moore
TYPE OR PRINT NOTARY
(SEAL)
P ��' Notary Public Slate of FLorde
Hannah E Moore
• My Commissmn HH 017099
Of, Expires 07101r2024