HomeMy WebLinkAboutFilled Land AffidavitPLANNING & 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,
ISO&
(Parcel Id#/Legal description/Address)
FL
RECEIVED
NOV 12 2021
6t, Lucie County
Permitting
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.
1 V i t2(k, KLouLo
Property Owner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OFi .
ACKNOWLEDGED BEFORE ME THIS \ DAY OF 20 a 1
BY tt ♦ IN6% :f\c—t \ O\) Q WHO IS PERSONALLY KNOWN TOME ❑() OR WHO HAS
PRODUCED '� `' 'j AS IDENTIFICATION.
SIGNATURE OF TARY PUBLIC
OMMISSION NUMBER
SLCPDSD Revised 04/11/2011
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TYPE OR PRINT NOTARY
p:t"v�B.. DEANNAGIVENS
'a°, �� Notary Public State of Florida
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`oFF My Comm. Expires Jan 28. 2025
Bonded through National Notary Assn.