HomeMy WebLinkAboutFilled Land AffPLANNING & 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
PK&Z 3T7i1/
(Parcel Id#/Legal description/Address)
described property, �� Z
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number 2199 1 - 0 3/y, racknowledge
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.
Date
STATE OF FLORIDA, COUNTY OF
ACKNOW GED BEFORE ME HIS DAY OF L 20
BY " WHO IS PERSONALLY KNOWN TO ME CM) OR WHO HAS
OF NOTARY P L C TYPE OR PRINT NOTARY
COMMISSION N
�aci'i� •.,, HELEN R. MORRIS
Notary Public . State of Florida (SEAL)
g Commission N HH 006200
o,. My Comm. Expires Sep 26, 2024
Bonded through National Notary Assn.
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
y —1W