HomeMy WebLinkAboutFILLED LAND AFFIDAVIT** 11__'_'/ 11
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division RECEIVED
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553 FEB 16 2022
St -Lucie County
FILLED LAND AFFIDAVIT Permitting
I, the undersigned, am the owner of the fpllowing described property,
13D I -Cou-oo15- ova- % / 1 keaxo d
(Parcel Id#/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.
--x x- I (scy--) C�D "--Y�
Property Owner Name (Please Print)
Pr 'Owner Signature
STATE OF FLORIDA, COUNTY OF S-�. LOG1*k
_2)-� - � �-p --2_02Z
Date
ACKNOWLEDGED BEFORE ME THIS DAY OF
IS PERSONALLY KNOWN TOME LID) OR WHO HAS
PRODUCED fl `— AS IDENTIFICATION.
SIGNATURE OF NC14ARY PUBLIC
TYPE OR PRINT NOTARY
"Cbk635'k COMMISSION NUMBER
DEANNA GIVENS
Notary Pub(gE`%te of Florida
c Commission # HH 086359
My Comm. Expires Jan 28, 2025
Bonded through National Notary Assn:
SLCPDSD Revised 04/11/2011