HomeMy WebLinkAboutFILLED LAND AFFIDAVIT - - - PLANNING & DEVELOPMENT SERVICES DEPARTMENT
a Building & Code Regulations Division
_ 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 RECEIVED
FILLED LAND AFFIDAVIT NO V 0 y 2021
St,Lucie
Permitting my
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/A dress),
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.
W. Bryan Adams
72:
Owner Name Please Print)
lli tt 1.
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS DAY OF k2b�M bpi' ,20 21 BY W. Bryan Adams WHO IS PERSONALLY KNOWN TO ME 01 OR WHO HAS
PRODUCED AS IDENTIFICATION.
Hannah Moore
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
017099 COMMISSION NUMBER
(SEAL)
P� Notary Public Slate or F4onda
Hannah E Moore
• My Commission HH 017099
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SLCPDSD Revised 0411 1/20 1 1