HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 4624553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
Z - (20q-b411-00C
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
7.04.0l(D)3 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 fiirther 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.
(Please Print)
ure Date
STATE OF FLORIDA, COUNTY OF �� P.���CJ
ACKNnO,W�LEDGED 1BEFORE ME THIS _ ir, Y=_DAY OF I'lD
BY It X f'F C' I� t164Y1 C�PZ �..�W� HHO IS PERSONALLY KNOWN TOME (� OR WHO HAS
PRODUCED_ \\l`P� �)C:E �/�IL �,( ASSIDENTIFICATION,
j\ L_Y,n1 n L �,� L Y 1
SI TUR F NOT Y PUELIC TYPE R PRINT NOTARY
COMMISSION NUMBER
(SEAL) �'rr ° Nolery Puhlic Slate of Florida
pA Robin L Bowen
�',aC EzpiC2s 02/04/2 23 28e272
SLCPDSD Revised 04111/2011