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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY Building& Code Regulations Division
2300 VIRGIMA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
a9/y-SYy-oo.2o-000-q R:yed**-ttN,+S 3UC '/3 Lo�.ZoCnfup jy/,78N) �c►�a68d •Ssa)
(Parcel Id#/Legal description/Address) b y Nc-: g-1.a C.ae H e
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , 1 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.
Prope Owner Name(Please Print)
Prop Owner Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNO DGED BEFORE E THIS I DAY OF 11.11 l I/�/' 20
V1/
BY v Lv W WHO IS PERSONALLY KNOWN TO ME(a OR WHO HAS
PRODUCED ap h DAS IDENTIFICATION.
SIG F Y PU IC TYPE OR PRINT NOTARY
COMMIS 10 NUMBER
(SEAL)
�y ,`� MARIA VEGA
�
_ Notary Public,State of Florida
9
Commission#GG 22960
SLCPDSD Revised 04/1 1/201 1 My comm.expires Oct.15,2023
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