HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
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 Id#/Legal description/Address)
for which I have applied to St. Lucie
accepting this Final Development Permi
that as owner of the above describe
7.04.01(D), St. Lucie County Land Devel
adequate drainage so that the immediate
I further acknowledge that in granting tl
St. Lucie County is neither obliged nor
adequate drainage off my property w.
community.
Owner Name (Please
Owner Signature
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS _9+1 I
BY c`�IJ�rI� �h7�la{zP�S WHO
ounty for a Final Development Permit. In
BP Number , I acknowledge
property, and in accordance with Section
lment Code, I shall be responsible for assuring
)mmunity WILL NOT be adversely affected.
permit for the development of this property,
ible to provide for, or maintain in any form,
;h will not adversely affect the immediate
Dat
IV
Y OF )Y `G 2CL 15
PERSONALLY KNO O ME (_) OR WHO HAS
AS IDENTIFICATION.
4�( I
SHARON K, NEWMAN
SIGNATURE OF NO ARY PUBLIC T 'O Rif T�blUN #EE-88 UM
o: P 8: April 20 2017
COMMISSION NUMBER
�Bonded Thru Notary Public Underwriters
(SEAL)
SLCPDSD Revised 04/11/201 I