HomeMy WebLinkAboutfilled land affidavit 116-5PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Moll 11 BuiIding & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462.1553
FILLED LAND AFFIDAVIT
1, the undersigned, am the owner of the following described property,
{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 , 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.
W. Bryan Adams
r_ Qwner Name (Pleas_ Print)
Property Owner Signature:' —
Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS _L _ _ DAY OF Z� �` 1
BY W. Bryan Adams _ �� _ _
WHO IS PERSONALLY KNOWN TO ME ([a OR WHO HAS
PRODUCED
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SIGNATURE OF NOTARY PUBLIC
017099 —_COMMISSION NUMBER
SLCPDSD Revised 0411IiZOI I
AS IDENTIFICATION
Hannah Moore
TYPE OR PRINT NOTARY —
(SEAL)
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Expires 0710172024