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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIROINIA AVENUE
FORT PI RCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Lepal deseripdoNAddress)
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.
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Property Owner Name (Please
ralt�4 . ca\o a
Property Owner Signatfic
Date
STATE OFFLORIDA. COUNTY OFST LUCIE
ACKNOWLEDGED BEFORE ME THIS 10 DAY OF JUNE ,2021
BY f E �� _ G, r WHOM PERSONALLY KNOWN TOME MOR WHO HAS
PRODUCED rn ) a.— AS IDENTIFICATION.
a. dje-
SIGNATURE OF NOTARY PUBUC V
-tt !0�l COMMMS]ONNUMBER
lj)4b « S /Z-i PL-
TYPE OR PRINT NOTARY
(SEAL)
3LCPDSD Revind 04/11/201 ] ,- r OEBQW S. VECaA
a o ; MY COMMISSION # HH 035431
EXPIRES: October 4, 2024
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