HomeMy WebLinkAboutFilled Land Affidavitr �-
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE, FL 34982-5652
(772) 462-1553 MAY 10 2021
FILLED LAND AFFIDAVIT Permitting Department
St. Lucie County
I, the undersigned, am the owner of the following described property,
4 I's 2 �/Vr Posit :41C ✓ e i 3 rye c'Sc) 4ore
(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.
1lQnofC-I--�0(-� j�
Property Owner Name (Please Print)
AA .-If nY �
roperty Owner Suture
STATE OF FLORIDA, COUNTY OF -6k.
Date
ACKNOWLEDGED BEFORE ME THIS �`� DAY OF �a11 .20&_,
WHO IS PERSONALLY KNOWN TO ME (n OR WHO HAS
PRODUCED t'' AS IDENTIFICATION.
�STGWAATUROF NNO Y PUBLIC
'A'Aak&%S \ COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
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TYPE OR PRINT NOTARY
04':Notary
DEANNA GIVENS
Public . State of FloridaCommission ,��f1H 086359-
"�28, 2025�AMy Comm. Exp
���Bonded through National Notary Assn.