HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
RECEP/er)
FILLED LAND AFFIDAVIT AUG ® 2 20?,f
St.facie County
Permitting
I,the undersigned, am the owner of the following described property,
a S Je-(n n , �lr P��e 1��3 ?_/Cc J a3 a 1 ,50/- yS
(Parcel Id#/Legal des ptiod/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number rlrm 9119Y-p6 7y 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 Owner Name(Ple ' Pri
;roperty�weer gnature Date
STATE OF FLORIDA,COUNTY OF J0.sn{ C i Q
ACKNOOWWL�EDGED BEFORE ME THIS DAY OF 20 Ott
BY VA WHO IS PERSONALLY KNOWN TO ME(8)OR WHO HAS
PRODUCED AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
GCl 3563g3 COMMISSION NUMBER
(SEAL)
NINA GIESE
Notary Public-State of Florida
I-K'a; Commission#GG 356393
My Comm.Expires Jul 17.2023
SLCPDSD Revised 04/11/2011 Bonded through Qional Notary Assn.