HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE, FL 34982-5652
(772) 462-1553 I U N 2 C 2021
St, Lucie County
PermittIng
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/Address)
-,�),8 5105 Pj.;kve D!, Ve
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.
Property O er Na (P ease Print)
✓� 5 1
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF S C. L4kC.
SWORN TO (OR AFFIRMED) AND SUBSCRIBED^ BEFORE ME OF PHYSICAL PRESENCE OR
ONLINE NOTORIZATION THIS DAY OF TwrL- 20 2%
NAME OF PERSON MAKING STATEMENT
PERSONALLY KNOWN OR PRODUCED IDENTIFICATION
TYPE OF IDENTIFICATION PRODUCED
SIGNATURE OF NOTARY PUBLIC
4m"j J COMMISSION NUMBER
SLCPDSD Revised 4/24/2020
TYPE OR PRINT NOTARY
(SEAL
08VP, JOHN SCHERER
%%P31- Pt,
Public-State of Florida
®oQc. Commission # HH 69519
M Commission Expires
%,� 0 F\� � y P
''11 December 06, 2024