HomeMy WebLinkAboutFilled Land Affidavit ' II
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division ,
j 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
I! (772)462-1553
FILLED LAND AFFIDAVIT
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I, the undersigned, am the owner of the following described property,
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i 'A ILA- 'Mk- to� h3- "Ay5 2 2 U13 SUB-fv avd A\ltm -e
I (Parcel Id#/Legal description/Address)
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for which I h Ive 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 j(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.
Proper Owner Name(Please Print)
Pr.4A
Property Owner Signature Date
it STATE OF FLORIDA,COUNTY OF IST y U C t P
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ACKNOWLEDGED i BEFORE ME THIS ! DAY OF 20 22
BY I IO1c�lrl CCn WHO IS P SONALLY KNOWN T (_❑)OR WHO HAS
PRODUCED AS IDENTIFICATION.
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SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
6b39 `2-Jz �COMMISSIONNUMBER
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LINDA HALL
�(•r�Q Notary Public-State of Florida
Commission#GG 309234
j My Comm.Expires Mar 7,2023
SLCPDSD Revised 04/I 1/201 F
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