HomeMy WebLinkAboutFilled Lands Affidavit �mO�1L 2r (Y11 r,> �- � ►tit t��t�w o vt I�
- PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-3652 RECEIVED
(772)462-1553
OCT 0 6 2020
FILLED LAND AFFIDAVIT St.Lucie County
Permitting
I,the undersigned, am the owner of the following described property,
3 Lwa cep-Ooo-.3
(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 4-1 lip- Of&!�j, 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.
c`r TO12 0
Property Owner Name(Please Print)
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF
ACIvI�f PLEDGED BEFORE MET S. DAY OF 20 0�+1
BY WHO IS PERSONALLY KNOWN TO ME( OR1WHO HAS
PRODUCED n AS IDENTIFICATION.
SIGNATURE OF NO Y YJBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
KAREN S.
NIELSEN
State of Florida-Notary Public
0; Commission # GG 207484
/ of F��� Nly Commission
SLCPDSD Revised04/112011 "� June 12 Expires
2022