HomeMy WebLinkAboutFilled Land Affidavit1
PLANNING& 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,
�3CA G®-7 —o`dqo -000- 9 77 00- SCQ ii��ioe,oAve.,
(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 , 1. 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.
A�)c Cl—d) C-3(xc s -
Property Owner Name (Please Print)
Property OwrTer Signature Date
STATE OF FLORIDA, COUNTY OF��i
ACKNOWLEDGED BEFORE Mg THIS a -U DAY OF J 120 4
BY h 6 Wn, WHO IS PERSONALLY NOWNTO ME (aOR WHO HAS
SIGNATURE UF"NOTARY. PUBLIC
G v 1)7 IUQV ' COMMISSION NUMBER
SLCPDSD Revised 04/11/201 I
AS IDENTIFICATION.
DY)nA. za.A6rq-�
TYPE OR PRINT NOTARY
RyNotary Public State of Florida
Donna Lea Askman -
My Commission GG 174054
E)kpires01/09/2022