HomeMy WebLinkAboutfilled Land Affidavit (2)PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, an, the owner of the fallowing described property,
(Pared ld#/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 , 1 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 m property which will not adversely affect the immediate
community. A
PropeiVlj Ow1kr Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF ,ST • `�1�( P
ACKNOWLEDGED BEFORE ME THIS _' ' ` _DAY OF I'T kiCo
BY nne 11((P�� MIIRSSY� y`CC/n�yA WHO
�ISPERSONALLY KNOWN TO ME (� OR WHO HAS
PRODUCED U i L 4 C M rA O n A" 1 A' "7 I- i S Qi - AS IDENTIFICATION.
FC (4, l ( �PRI I n AR 3C)W �f1
SIGNA URE OFF NOTAR� P LIC � TYPE OR PRINT NOTARY
GG aQPl�I2 COMMISSION NUMBER
(SEAL)
SON x4s. Notary Public State of Florida
`h Robin L Bowen
<. a My Commission GG 288212
SLCPDSD Revised 04/11/2011 cr w Expires 02/04/2023