HomeMy WebLinkAboutFilled Land Affidavit! \ {r
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGD41A AVENUE
FORT PIERCE, FL 34982-5657
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3901 ST LUCIE BLVD 34953
(Parcel 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 1 � - I acknowledge
that as owner of the above described property, and in accordance with Section
704.01(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 propertywhich will not adversely affect the immediate
community.
Property O Na a lease Print)
q,30 -1 %
T!operty 9 ner Sigr- ture Date
STATE OF FLORMA, COUNTY OF
ACKNOWLEDGED BEFORE MET
, HIS DAY OF
BY ' �'�QS A- /A/�(/Y1 WHO IS PERSONALLY KNOWN To ME CE&RWHO HAS
PRODUCED
S.IIGGNATURE OFNOT PUBLIC
ql3lyg COMMISSION NUMBER
SLCPDSD. Revised 04/11 /2011
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
(SEAL)
qG� . H A C"anic noo of
a
4' * PAY Con" Neion GG 913147
arrW' Expros 12/ 2023