HomeMy WebLinkAboutFilled Land AffidavitAm
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PLANNING & 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,
book vine -wee �Y
(Parcel id#/Legal description/Address)
D#4- 3402- CoUl OU-1 LA- OOv- b�
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , 1 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.
f-IIV-c �•� c S
Proper er Name (PI se Print)
Property Owner Sign tore Date
STATE OF FLORIDA, COUNTY OF�
ACKNOWLEDGED BEFORE ME THIS 222hd DAY OF 20Aa-'
BY WHO 1S PERSONALLY KNOWN TO ME (n) OR WHO HAS
PROPPCED A AS IDENTIFICATION.
I I —
ATURE OF -NOTARY PUBLIC
&2IMC(I ( _CCOMMISSION NUMBER
SLCPDSD Revised 04/11/2011
N1 coO c okfhcson
TYPE OR PRINT NOTARY
NICOL£ ELLENSON
MY COMMISSION #GG089104
EXPAW& O2, 2021
Bonded through let State Insurance