HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 RECEIVED
(772) 462-1553
FEB 2 3 2022
FILLED LAND AFFIDAVIT St.,Lucie County
Permitting
I, the undersigned, am the owner of the following described property,
t l oa PL P-T 0 -,-03 -033 Y -00012,
(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 S� K NarK -
PropAty Owner Name (Please Prin )
— &A�� '�< q��&
Property Owner Signature
STATE OF FLORIDA, COUNTY OF
a-/8-9C)
Date
ACKNOWLEDGED BEFORE ME THIS t 06 AY OF I (i5/'l.�iltll.i S�h 20 QQ ,
By LI� �L yV t tt+� ,\ /WHO IS PERSONALLY KNOWN T1O` MMEfLo OR WHO HAS
PRODUCED T I OY I A G U. "�Y I�I (e J 6L f I Oyv`� AS IDENTIFICATION.
.:�I C, vLt�
SIGATC�URE OF NOTARY PUBLIC TYPE OR P T. NOTARY
H ' IN6q W COMMISSION NUMBER
(SEAL)
SLCPDSD Revised 04/11/2011
lWYLA RICH
o� Notary Public
State of Florida
o$410E
Comm#HH183460
� Expires 10/7/2025 .