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M
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRWHA AVENUE
FORT PIERCE, FL 34982 5652
(772) 4621553
FILLED LANDS A]FMAViT
L the undersigned, am the owner of the following described property,
9
(Parcel IdNLepl
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
1.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WML 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.
Rrad)e_yr e r-
waer
Owner Signature Datd
STATE OF FLORIDA. COUNTY OF 54 L u a), e-
ACKNOWLEDGED BEFORE M/E�THIS �o�ZDAY OF Tt, A W Ce /1 / 20 1 5�
BY jBtP' Q Gi) IG U tr P &9Lej— WHO 1S PERSONALLY KNOWN TO ME ✓ OR WHO HAS
PRODUCED AS IDENTIFICATION.
19,AK ,- K)giL L L Qee bola h S R o ell
SIGNATURE OF NOTARY PUBLIC TYPE ORPRINTNOTARY
F E I'G60 & & COIuWSSION NUMBER'
Notary Public State of Florida
Deborah 1] ell
�o My Commissilo``n ��E 196066
opaor Expires05106/2016
SLCPDSD Revised 08124/2010