HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING.& DEVELOPMENT SERVICES DEP.
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553,
FILLED LAND AFFIDAVIT
AUG 2 4 2021
ST. Lucie County, Permitting
I, the undersigned, am the owner of the following described property,
►�o� P 163n- WED- obo - �
(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..
Pr erty Owner Name lease Print)
Pr perry Owner Signature Date
STATE OF FLORIDA, COUNTY OF 5� U0``-
ACKNOWLEDGED BEFORE ME THLS DAY OF 20�,
BY V\Pkl`�— l) V 6T 70' ` WHO IS PERSONALLY KNOWN ME (El OR V1140 HAS
PRODUCED
1GGN�ATU OF /NOTARY PUBLIC
CMW "� (COMMISSION NUMBER
SLCPDSD Revised 04111/2011
OR PRINT
(SEAL)
IDENTIFICATION.
Ashley Jones
*NOTARY PUBLIC
STATE OF FLORIDA
Comm# GG969944
601Expires 3me12024