HomeMy WebLinkAboutFILLED LAND AFFIDAVIT PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462d553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described properly,
Go �r fr j6c ocr 3 95no A�� s /8700 7tQ �4>wtf ,-y ��1 reLA�tE
(Parcel IM/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 , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.0l(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 Owner Name (Please Print)
Prep rty Owner Si aturd�;eK Difte
STATE OF FLORID COUNTY OF �%. CLcG4 CS
ACKNOWLEDGED BEFORE METHIS �� DAYOF
BY / /YO mA �I� • �YJ f5N 7AalA- WHO IS PERsoNaLLY KNOWN10 NIB (LA OR WHO HAS
PRODUCED AS IDENTIFICATION.
1� .¢�rA.r� / / f
SIVqATURB OFF NOTARY-PU13LIC TYPE OR PRINT NOTARY .
COMMLSSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011 pNpEWitL$
fit• " ° ComMuan # GG272813
a Ex 1tesFe4tuary. 20,2023
.p .`• P PoInlnNtanae 8pp�09.1019
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