HomeMy WebLinkAboutFILLED LAND AFFIDAVIT `4r 1
r PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations DivisionCOUNTY
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2300 VIRGINIA AVENUE i
FORT PIERCE,FL 34982-5652 i
(772)462-1553
fFILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
' 13 I �, - 403( r _0005-0oof l
(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
commu
i
Property O i ame(Please Print)
of 1201q,2
Property Owner Signature Date
I
STATE OF FLORIDA,COUNTY OF S LLA
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ACKNOWLEDG D BEFORE ME THIS_ _DAY OF "'ain ,20 05-4 ,
BY I,,,Qe I �t17�IQZ WHO IS PERSONALLY KNOWN TOME LE11 OR WHO HAS
PRODUCED F AS IDENTIFICATION.
SIGNATURE OFI Y PUBLIC TYPE OR PRINT NOTARY
I I
C MMIS7-
SLCPDSDr_1
ELLEN VAU G HN (sEAr.)ate of Florida-Notary Publicommission # GG 270079MY Commission Expires8etebbr 221 2022
PDSD Revised 04/11/2011
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