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PLANNING & DEVELOPMENT SERVICES
Building & Code Regulations Di
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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,
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'(Parcel !d#1Legal description/Address) c y
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Pen -nit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.44.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community )YILL 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.
Wz og
Property Owner Name a Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE: ME THIS --=-K-------- DAY OF---.-J^fil . 20 2 1
BY I , .
WHO IS PERSONALLY KNOWN ! O ME (} OR WHO HAS
PRODUCE � / � A$ IDBNTCFiGATION;
&IONA FOTAR YT Q TYPE OR PRINT NOTARY )
�L �'OMMISSION NUMBER
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COLLIN MIHAI OUNN-------
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tinTARY 6%lt19t it
REGlS7fiAiION 0 7774192 �
COMMONWEALTH MMONWEALTH OF VIRGINIA
MY COMMISSION EXPIRES
MARCH 312 22
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