HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & 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 following ,describfed, prep rty,
(Parcel Id#/Legal description/Address) ,
,for which I have applied Ito !'-St'.; Lucie,.:Co:unty for -a.. F•inal' Deve opment Permit. In
accepting • this : Final Development Per BP Number , I acknowledge
that as owner of the above described property; and in accordance' with Section
7.04.01(D), St: Lucie County Lnnd`pevelopinOnt,Qode; hshall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this, per`iriii for'the`development'of-this •property,'
St. Lucie County is neither' -obliged n'or- liable to'•�providle''for," or, `maintdin"in': any form,
adequate drainage - off my 'property which', will not,'•adversely.' affect the 'uririiediate
community.
W. Bryan Adams
_�-Es Owner Name Please Pririt)-' ,..:. '
Property Owner Signature
.' ... <m... Date
STATE OF FLORIDA, COUNTY OF St Lb die':
ACKNOWLEDGED BEFORE ME THIS" , j 0AY OF ( [ / e-
BY W. Bryan' Adams IjWHO IS -PERSONALLY KNOWN TO ME OR -WHO HAS
PRODUCED ' ,
AS IDENTIFICATION.
\I IVn Hannah Moore
IGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
017099 COMMISSION NUMBER
(SEAL)
�q•°w� Notary PuD6e 5tete'of F�oh
Hannah E Moore '
SLCPDSD Re4i§ed 04/I 1/2011? MY Commission HH 017099
or nQ Expires 07/01/2024
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