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,
3 �foa-yob.
(Parcel Id#/Legal
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 Owner Name ase Print)
ronertY Owner &4iraZge
STATE OF FLORIDA, COUNTY OF� ��
Date
ACKNOWLEDGED BEFORE ME THIS � `f' DAY OF � 20�I ,
BYSIO12A 11 Ma-Z��1�.., WHO IS PERSONALLY KNOWN TO ME � OR WHO HAS
Rl7H�JCED rl bL '.yn�—�3�0'F5 �7— ��—� AS IDENTIFICATION.
1)1,rff6er
SIGNATURE OF NOTARY PUBYIe TYPE OR PRINT NOTARY
COMMISSION NUMEER
(SEAL)
pisSHANNONMITrLER
MY COMMISSION#GG203869
EXPIRES: June 11, 2022
SLCPDSD Revised 04/I1/2011 Fp'ri„O�W' BondedThra Notary PUNCUMOMOM