HomeMy WebLinkAboutFilled land affiPLANNING & DEVELOPMENT SERVICES DEPARTMENT
s 1 J " Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34992-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
--3og - Coos -cc 3t, -too _5
(Parcel W/Legal deseription/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.
AI N DoNnWan
Property Owner Anic (Please Pnnt
Property wne signature Date
STATE OF FI,ORMA, COUNTY OF �-T W CA e�_
ACKNOWLEDGED BEFOORE,ME TF41S + U DAY OF + CLfi C , 2e
BY rQ V wH0 IS PERSONALL Y KNOWN TO ME (X OR WHO HAS
PRODUCED
A -aid.
SIGNATURE�O}F NOTARY LlC
�Q3 7951 cOMMISSION NUMBER
SLCPDSD Revised 04/1112011
AS IDENTIFICATION.
Lad S. &refer
TYPE OR PRINT NOTARY
'
(SE_AL, �Y %.us
flj� ;�c'Illia S. Bre
��..PCotrtm.#H4iO3T9�
. Expit�: Sept 15,
�'��f::s►�`'�'� GgndedihN
Aaron WM