HomeMy WebLinkAboutFILLED LAND APPLICATIONPLANNING & DEVELOPMENT SERVICES DEPARTMENT
COUNTY � Building & Code Regulations Division
2300 VIRGD41A AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
i4t405 -_: i . s ( �E , FL _ y98
(Parcel IM 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 �?p! - d y ,_ y , 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 no t adversely affect the immediate
community.
� E
Prop e wn sc Print
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF�
ACKNOWLEDGED BEFORE ME THIS DAY OF A4CjWJj 20 2 Z;
BY _ 7V) C_ IA �—WHO IS PERSONALLY KNOWN TO ME Q OR WHO HAS
PRODUCED d �lI IYSV}�� �QI AS IDENTIFICATION.
SIGNATURE OF NOT Y PUBLIC TYPE OR PRINT NOTARY
EZ
_COMMISSION NUMBER;Rssr Notary Public
State of Florida
Commission A GG 950931
My Comm. Expires May 18, 2024
Bonded through National Notary Assn.
SLCPDSD Revised 04/11 /2011