HomeMy WebLinkAboutFILLED LAND AFFIDAVITM
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
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 follow' g descri eo property,,? •,SO/• UID.$G 'DOD. So
Ne—N'4.2/E.v �04�M S $e— 1...4 7" 5/
2 71V411- 23/eO4-S".17x- JW
(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.
Pro Owner Name2(pliase Print)
,1 ,1Fade � Z 71
Property Owner Sigfafure Data(
STATE OF FLORIDA, COUNTY Q12=94-,0
ACKNOWLEDGED BEFORE YJ THIS 277 DAY OF , 20_Z/,
BY .¢,e./ Q461_4-F77 WHO IS PERSONALLY KNOWN TO ME 0�5 OR WHO HAS
COMMISSION NUMBER
t
SLCPDSD Revised 04/11/201 I
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
(SEAL) P(/
SHERRI FEHLMAN
o�PgY
Commission # GG 187160
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o
Expires March 14, 2022
SIFOF F`oQ-
Bonded Thru Budget Notary Services