HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
J " Building & Code Regulations Division . F`sG�iv�p
2300 VIRGINTA AVENUE ®,�1
FORT PIERCE, FL 34952-5652
(772) 462-1553 �Q� meet
pePa�' tv
Per�rt4g
FILLED LAND AFFIDAVIT 5
I, the undersigned, am the owner of the following described`propetty,
1 3 o i. • rQ � 3 • a� (oto �o - � Lc>Llc3a�_a�c�� Rxnc, lA'1)fi I k. t �
(Parcel Id#/Legal description/Address)
7 c O o2 'D�F" PCr< rk�
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
7.04.01(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.
f \Cr t-l� "CC 14)&`
Property Owifer Name ( ase Print)
Prb vn_ec Signature D� e
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS Ua tl" DAY OF DPCerYti'%ee 20
BY _M Ems' CA `[� 0 Al P— WHO IS PERSONALLY KNOWN TOME (a) OR WHO HAS
PRODUCED
SIGNATURE OF NOTAR LIC
14 AQagQ IOCOMMTSSION NUMBER
IDENTIFICATION.
if calm_m_ r 10 czief)l I, >o
TYPE OR PRINT NOTARY
(SEAL)
SLCPDSD Rcviscd 04/1 1/201 1 I% wow r1bk1w 9d RW.WN
• ' CommiMfOn MN 02�010
Ears OelO6=4