HomeMy WebLinkAboutFilled Land ApplicationPLANNING & 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 to lowing .described property,
�- 4`l 7- P►,Zed Pltiosr7�" S:2o7 oeer Ruin or�ue FeriV Rc-r , tiZ 3 `� 1
(Parcel IM/Legal desc iption/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , T acknowledge
that as owner of the above described property, and in accordance with Section
7.04,0.1(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, of maintain in any form,
adequate drainage off my property which will not adversely affect the immediate,
community.
.Al n r k A. 3," fk a
Property Owner Name (Please ribil)
) 4. ,�4� � 16Ag,/:zI
Pr perty Owner Signature Date;
S•i'ATEOFFLORIDA, COUNTY OF
1�
ACKNOWLEDGED BEFORE ME THIS ( DAY OF � C� 11 � 20f Q.
BY A s, A � 7� } WHO TS PERSONALLY .KNOWN TOME (C,) OR WHO"HAS
PRODUCED AS IDENTIFIC ATION-
QIONATURE OF NOTARY PUBLIC TYP oR 1rRNT NOTARY
?COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11 /2011
C'INR
r(J 8IR K aANSIL3co;tc. 5tate,6t Florida
Comm'ssfor-KN 90363
`Oa M)'.Camm, s"z�ires --eo 8. 2025
30rCe. thr;cgh NaticPa' -Notary Assr„