HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE, FL 34982-5652
(772) 462-1553 MAR 18 2021
Permitting Department
FILLED LAND AFFIDAVIT St. Lucie County
I, the undersigned, am the owner of the following described property,
Shy- 1�0 3 -006-7- 0a`
(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 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.
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s �v � s&411 I f
P operty er Name (Please Print)
Pro Owner Signature Date
STATE OF FLORIDA, COUNTY OF S-�- "
ACKNOWLEDGED BEFORE ME THIS \�
BY'J qb0 V
PRODUCED L--
...
SIGNATURE OF NO �YPUBL�IC�
Nh4'1 " !&COMMISSION NUMBER
SLCPDSD Revised 04111/2011
DAY OF m"** t 20 a
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
AS IDENTIFICATION
TYPE OR PRINT NO Y
v'6ii" DEANNA GIVENS
i*P i� public . State of Florida
'o nt Notary
_ <'• Commission # HH 086359
o n, 28,,,2025
+ of moo?= My Comm. Efc�fi� Assn.
Bonded through National Notary