HomeMy WebLinkAboutFilledLandAffidavit_ signedPLANNING & DEVELOPMENT SERVICES DEPARTMENT
990
Building & Code Regulations Division
• 2300 VIRGINIA AVENUE
11
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
1436-602-0017-000-2
(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.
Jill Liddell
Property Owner Name (Please Print)
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P ty Clignature date
STATE OF FLORIDA, COUNTY
ACKNOWLEDGED BEFORE ME THIS DAY OF 20
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BY �1 1 1 1 �'I \ WHO IS PERSONALLY KNOWN T�ME ORWHO HAS
PRODUCED �� �� \, 't)AF S Li C 4&4S ff AS IDENTIFICATION,
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
& L aS 7L L3 COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
(SEAL)
MEWDIE STARR
Notary Public State of Florida
�: ; • .
Commission 9 GG 257497
�? o` My Comm. Expires Sep 11, 2022
Bonded through National Notary Assn.
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