HomeMy WebLinkAboutFilled Land AffidavitSLCPDSD Revised 04/11/2011
PLANNING.& DEVELOPMENT SERVICES. DEPARTMENT
Building_ & Code Regulations Division:
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 4624553
FILLED LAND AFFIDAVIT RECEIVED
JUL 15 2021
St, Lucie County . .
I, the undersigned, am the owner of the following. described property,'tti"g
(Parcel Id#/Legal description/Address) as
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.
'p-0-w5y"q- J, C_",,Hovw
Property Owner Name (Please Print)
_ 3/Zq z1
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF Lad
ACKNOWLEDGED BEFORE ME THIS �( DAY OF 20 0�
BY y-► 0�_�LL&N WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
..PRODUCED. AS IDENTIFICATION.
NLV_�j - tlf�'
SIGNATURE . NOTAR PUBLIC TYPE OR PRINT NOTARY
G1
G -1 `� 06 ! -COMMISSION NUMBER
Notary Public State of Florida
Donna Lea Askman-
g My Commission GG 1,74054
o Ez ices 01/09/2022
or,, 19 P