HomeMy WebLinkAboutMarin - Filled Lands Affidavit AL
PLANNING.&DEVELOPMENT SERVICES DEPARTMENT
BUILDING&CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-I553
FILLED LANDS AFFIDAVIT
1,the undersigned, am the owner of the follow' g described property,
2--- 5, Z- Oo P ►U 0. 0-4
(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 , 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.
Property Owner Name 'se Print)
Property Own - ignature Date
STATE OF FLORIDA,COUNTY OF , �(,U U e,
ACKNO EDG BEFORE E THIS DAY OF_ 20 `
i
BY ( TVMO IS PERSONALLY KNO�N TO ME OR WHO HAS
I
ED - AS IDENTIFICATION.
OF NO PUBLIC TYPE OR PRINT NOTARY
7
COMMISSION NUMBER ✓+" "``
�Y Pp !Votary Public State of Florida
(SEAL $° Francene Newman
o- My Commission GG 221434
Expires 05/23I2022
SLCPDSD Revised 0812412010