HomeMy WebLinkAboutFilled land affidavit z;- PLANNING & 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 described property,
9? 0( C4Y us 7ayL 'l u , P643r-eK42
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Develop ent 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 Developmen/Cde, 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.
43 -za ak"
Pro Owner Na e Please Print)
Property O Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS _DAY OF V 2019A ,
BY '70++ O IS PE NALLY KNOWN TO ME t 0 OR WHO HAS
PRODUCED 1 AS IDENTIFICATION.
SIGNATURE OF NOTARY PUBLIC TYPE OR PRI T
AMMIS SION NUMBER
s ELLEN VAUGHN--State of Florida-Notary Public
*_ Commission # GG 270079
i,E OF Fro@J MY Commission Expires _
October 22, 2022
SLCPDSD Revised 04/11/2011