HomeMy WebLinkAboutFilled Land Affidavit Y
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
22.� Building&Code Regulations Division
I 2300 VIRGR41A AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
I '
i FILLED LAND AFFIDAVIT
I,the undersigned, am the owner of the following described property,
q VfY-Y-Ion A4 Rtree 7roctda 3`RI?-Z.
(Parcel Id#/Legal description/Address)
for which-1 -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
i 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,
I 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.
Cat fvr
operty Owner Name(Pleas int)
'Property Owner Signature 0Date
STATE OF FLORIDA,COUNTY OF
IACKNOWLEDGED BEFORE ME THIS DAY OF 20__c24__
(� I ,
BY \0 ���C^^l(� ' WHO IS PERSONALLY KNOWN TOME ❑U OR WHO HAS
PRODUCED J / AS IDENTIFICATION.
SIG/.NAT^U�RE OF NOTARY PU]ILM TYPE OR PRINT NOTARY
oMMISSION NUMBER
(SEAL)
pW ups
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