HomeMy WebLinkAboutFilled Land Affidavit i
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553
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FILLED LAND AFFIDAVIT 1
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I,the undersigned, am the owner of the following described property,
JZoo 6Ry- Avv, Co(J- P(tac(f, rL 3LNOZ
(Parcel Id#/Legal description/Address)
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 I developmeii t 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.
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C_k C, ge-4
Property Owner Name(Please Print)
Property Owner SignAuA Date
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STATE OF FLORIDA,COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF /V ( v 20
BY I I'f 1T D WHO I PE ONALLY KNOWN TO ME OR WHO HAS
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PRODUCED { ��. �' �� I —AS DENTIFICATION.
—&Zap-
SIGNATURE OF VARY PUBLIC V TYP R PRINT NOTARY
COMMISSION-NUMBER
(SEAL)
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-. Bl; RI Y B.HUMPHREY
SLCPDSD Revised 04/11/2011 0. 6- b96dISS,ON#FF 174772
Ml' March 6,2019
EX?r-tES:
".? °` d TbN Notary Public Undznv lens
Y'6g AUDREY B.HUMPHREY
_� •• ' MY COMMISSION.#FF 174772
EXPIRES:March 6,2019
cc o Bonded Thrd Notary Public Undeiwriters
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