HomeMy WebLinkAboutFILLED LAND AFFIDAVIT PLANNING & DEVELOPMENT SERVICES DEPARTMENT
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Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
5711 Hickory Drive Ft. Pierce, FL 34945
(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 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.
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Property Owner Name(Please Print)
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Property t4er Signa e Date
STATE OF FLORIDA,COUNTY OF�1/n Mzh
ACKNOWLEDGED BEFO �!ME THIS C DAY OF J&4—
BY ��I�(,�L r .111 WHO IS PERSONALLY KPOWN TO ME OR WHO HAS
PRO AXED AS IDENTIFICATION.
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SIqNATUTRE nNCO�T�ARY PUBLIC TYPE OR PRIN NOTARY
0� 01 K eJMMISSION NUMBER
��pv Pue4., TONYA Sr TT
Notary Public State of Florida
A " Commission#HH 048045
o� My Comm.Expires Sep 29,2024
Bonded through National Notary Assn.
SLCPDSD Revised 04/11/2011