HomeMy WebLinkAboutFilled Lands ApplicationPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
La7" 839 VniTu RE oul �1'D yS/i -,1'/0 - 003 Y- 0 00 - y
(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.
"L 4b 407i` GiA3 &0?4 iuG }►NTAi. G1)06945
Property Owner Name (Please Print)
Property Owne6lSignature 1 fr Date
STATE OF FLORIDA, COUNTY OF.
ACKNOWLEDGED BEFORE ME THIS 015 DAY OF 20,
�Ll1u� e,-7e CFEKa L� r1 �
BY i_ Ino.y"13-L T %WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PReSUCED—, • D/ 1— AS IDENTIFICATION.
OF NOTARY LI TYPE OR PRINT NOTARY
COMMISSION NUMBER
a�,, DAVIQ N. KNEPPER
Commission #,DDgM8
QQ` Expires September25, 2014
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SLCPDSD Revised 08/24/201.0