HomeMy WebLinkAboutPiper Filled Land AffDocuSign Envelope ID: 24A00F89-BFD0-4E8B-BF01-F341511 F87FB
_- PLANNING &DEVELOPMENT SERVICES DEPARTMENT
k - _ 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,
(Parcel ld#/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.
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Pn?pgu 1&,MV.aN&Vne (Please Print)
Prl,percy�r�rL�Pssire Date
STATE OF FLORIDA. COUNTY OF S! . J 42 e
ACKNOWWLpEDOED BEFORE ME THIS a DAY OF D&eA-04 ,20 a I
BY YtiJ WHO IS PERSONALLY KNOWN TOME (03) OR WHO HAS
PRODUCED lJ L AS IDENTIFICATION.
_ ,_gyp • S� 5�-
SIGNATURE OF NOTARY PUBLIC
Kerry A. Sisson
TYPE OR PRINT NOTARY
COMMISSION NUMBER
(SEAL)
REK
c State of Florida
sonion GG 950211
SLCPDSD Revised 04;I I,2011 2I2024