HomeMy WebLinkAboutFilled Land Affidavit s;. t Jn_� PLANNING &DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAV
IT
I,the undersigned, am the owner of the following described property,
Spa 00-01 0A,o b, (66 :5-2-Yo) 61-/1- 75 4o f-10 64303 -�s 7)
(Parcel Id#/Legal description/Address)
y
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit BP Number Toy• O!I I acknowledge
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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(Please Print)
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF �.
ACKNOWLEDGED BEFORE ME THIS l DAY OF 20jj_
BY . z/�, J9 it?yn 4 r- WHO IS PERSONALLY KNOWN TO ME 4 )OR WHO HAS
PRODUCED �- AS IDENTIFICATION.
1G ATURE NOTARY PUBLIC TYPE OR PR NOTARY
COMMISSION NUMBER
(SEAL)
,F�'"'•"ti;: MARY ANN MATONTI
SLCPDSD Revised 04/11/201 I MY COMMISSION#FF953138
?a 34; EXPIRES January 24.2020
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