HomeMy WebLinkAboutFilled Land Affidavit 6-14-16i
- - PLANNING & DEVELOPMENT SERVICES DEPARTMENT
o Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
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FILLED LAND AFFIDAVIT
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I, the I undersigned, am the owner of the following described property,
L�%i 3 - lae--< .v lc/:� mod;. GLC!CevzjIV- �, c�C_ pl-d ,.,d2 �i T
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(Parcel Id#/Legal description/Address)
Ir`ec5t�. S i2`CG4—`Cyj,5, `{ 0-e n iI? !'2e> ce,Ki
for which I have applied to St Lucie C t f F' 1 Ft-bP ` IAA
oun y or a anal 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 fin ther 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 unmcdiate
community.
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Proper er Name (Please Print)
Gi'c'��.'YVZLin�
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF�
ACKNOwLEr)GF.D 13EFORF ME -PHIS_ L��, . _ DAY OF C , 2U :%•(e ,
13Y _ i r e:y (-13 1�
Q 1i WHO is PERSONALLY KNOWNTO ME (_ - VR WHO HAS
e , ,1_
/ COMMISSION NUMBER
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SLCPDSD Rcvised04/11/_'U11
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AS IDENTIFICATION.
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TYPE OR PRINT NOTARY "
tSa�l>t1� � HeTchef
NOTARY PUBLIC
STATE OF FLORIDA
. Comm# FFOMI
Expires 8/1=017