HomeMy WebLinkAboutFilled Land Applicationj�
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
14 Building & Code Regulations Division
_ 2300 VIRGINIA AVENUE
• FORT PIERCE, FL 34982-5652 fill
(772) 4t2-1553
.�U�� 2011
FILLED LAND AFFIDAVIT
St. Lucie roui_,:, ;-!-
I, the undersigned, am the owner of the following described property,
tot A6)oA QA QRWE JE/JSe/J E?�flckFL-
(Parcel Td#/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.
Prag er Name (PIC t)
4W
Property er Signature
STATE OF FLORIDA, COUNTY OF M/lFL(I A/
Date
ACKNOWLEDGED BEFORE ME THIS �! DAY OF
BY fiAJQI 0jS /�&�M/ ,44 WHO IS PERSONALLY KNOWN TO ME (_) OR WHO HAS
PRODUCED � AS5Pg/-% S6,5'0553 i�, AS IDENTIFICATION.
SI TURE F N ARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER ,yy,
JULIE M SCALISE
MY COMMISSIMMG081020
,a,,•.•` EXPIRES April 08, 2021
SLCPDSD Revised 04/11/2011