HomeMy WebLinkAboutFilled Land Affidavit PLANNING &'DEVELOPMENT SERVICES DEPARTMENT
Building& Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 °►
(772)462-1553 C O V D
FILLED LAND AFFIDAVIT OCT 2 6 2017
PERMITTING
St. Lucie County, FL
I,the undersigned, am the owner of the following described property,
(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 1109-Q 4 jrj,, 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.
L� NE
Property Owner Name(Please Print)
!,v ?
Prope6y Owner Signature Date
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS `t2 DAY OF 20 ,
BY V.)f)Y k °l, �` h+WHO IS PERSONALLY KNOWN TO ME ❑U R WHO HAS
PRODUCED AS IDENTIFICATION.
SI��TAR P �LIC TYPE OR PRINT NOTARY'
COMMISSION NUMBER
KAREN S. NIELp1L)
+° �= Commission# FF 115637
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My Commission Expires
June 12. 2018
SLCPDSD Revised 04/11/2011
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