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,
�accl i3.o f- oa - oo3s a AL&e,
(Parcel Id#/Legal description/Address) 3 ey qS)
L.,
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number I , 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 Nam lease Print)la:�z--
/,)-
roperty Own Signature Date
STATE OF FLORIDA,COUNTY OF�nCj
ACKNOWLEDGED BEFORE ME
/ME THIS _DAY OF cO j/1�� 120 p
BY V
WHO IS PERSONALLY KNOWN TO ME(Pa OR WHO HAS
------------
PRODUCED AS IDENTIFICATION.
SIGNATURE
O r ARY PUBLIC TYPE OR PRINTIN TARY
tcor— COMMISSION NUMBER
(SEAL)
,kA� Pu''• CATHY J ROBERTS
?°•�1���; Notary Public•State of Florida
SLCPDSD Revised 04/11/201 I j c` Commission>Y GG 316785
!�o`r r 5 My Comm.Expires May 10,2023
Bonded through National.Notary Assn.