HomeMy WebLinkAboutFILLED LAND AFFIDAVIT 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,
3414-501-1412-100-7/ST LUCIE GARDENS 25 36 40 BLK 2 S 165 FT OF N 330 FT OF LOT 12(1.31 AC)(MAP 34/25N)
(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 , 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.
JAv1 t rLA-V -
Property Owner Name(Please Print)
Property Signature Date
STATE OF FLORIDA,COUNTY OF lJ►.�
ACKNOWLEDGED--B11EFORE ME THIS DAY OF ae 1(U lV 20
BY,1 lU 11 tQ Y _ WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED n I AS IDENTIFICATION.
SIGN ATU ER OF NOTARY P LI TYPE OR PRINT NOTARY
Z COMMISSION NUMBER
(SEAL)
r�ty Notary Public State of Florida
SLCPDSD Revised 04/11/2011 `F Melissa D Showman
My Commission GG 294495
A Expires 01/24/2023