HomeMy WebLinkAboutFilled Land AffidavitPLANNING & 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 following described property,
2 6qD0 J�ee-j 60/, 331 0061 coo
(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 drain off m property which will not adversely affect the immediate
Owner Signature
STATE OF FLORIDA, COUNTY OFZA A' An
R :vet
l X07-
Date
ACKNOWLEDGED BEFORE ME THIS 9-1 DAY OF 0G4ObCi 120 2
BY (`YOL(% Re•e a WHO IS PERSONALLY KNOWN TO ME C OR WHO HAS
PRODUCED
AS IDENTIFICATION.
JSA
042eyf-wrz
IGNATURE OF NOTARY PUBLIC
TYPE OR PRINT NOTARY
C-0 4f WCOMMISSION NUMBER
(SEAL)
SLCPDSD Revised04/I1/2011
1;aYP"'••; JONATHAN D MFORD
s?°• `. Notary Public-StateofFlorida
Commission ; GG 948388
oc° My Camm. Expires Apr 19, 2024
Bonded through National NotaryAssn.