HomeMy WebLinkAboutFilled land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 Rr- 1=T Pr?
FILLED LAND AFFIDAVIT
OCT 0 4,
ST. Lucie County, Permitting .
I, the undersigned, am the owner of the following described property,
'02-33i - G01-0019.000-8
(Parcel Id#/Legal description/Address)
s Two (
3j1'?'4 5
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 O me (Please Print)
a. Z7. Zf
Proper r Signature Date
STATE OF FLORIDA, COUNTY OF W C��
ACKNOWLEDGED BEFORE ^MEE THIS 2------------ DAY OF _ _------___ 20—�__-- '
BY PC C�C"� COA"' WHO IS PERSONALLY KNOWN TO ME (E) OR WHO HAS
PRODUCED IZ— 109 E?A N/�—IYG� �L ZS�. AS IDENTIFICATION.
T ATURE OF N('LJBi TYPE. OR PRINT NOTARY
C4`'i OSMIALCOMMISSION NUMBER
OR �{NDO1VAZQUEZ
kate of Florida
Notary
Commission 4 GG 189841
26, 2022
My Comm. Expires Feb
Bonded through National Notary Assn.
SLCPDSD Revised 04/11/2011
V.