HomeMy WebLinkAboutFilled Land Affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Divisionmum _
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652 = -
(772)462-1553 JUL S 0 9"021
FILLED LAND AFFIDAVIT ST.Lucie County, Permitting
I,the undersigned, am the owner of the following described property,
1)6 Pot.4,G Ave, rotes , e�Afu
(Parcel Id#/Legal descript on/Address)
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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 m property which will not adversely affect the immediate
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community.
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Property Owner Name(Please Print)
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Property Owner Signature Da e'
STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS C�DAY OF
BY 1r l� a. fat, WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGNAITRE[OF NOTARY PUBLIC TYPE OR PRINT NOTARY
Jet) OMMISSION NUMBER
(SEAL)
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SLCPDSD Revised 04/1 1/201 l ;=ot c;'i JEANA L PITTS
Notary Public-State of Florida
Commission#GG 338475
My Comm.Expires May 27,2023
Bonded through,National Notary Assr.
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