HomeMy WebLinkAboutFilled Land Affidavit- 1 �,�;�,�, PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE; FL 34982-5652
(772) 462-1553 RECEIVED
FILLED LAND AFFIDAVIT JAN 12 2022
St. Lucie County
Permitting
the undersigned, am the owner of thefol0owing describ d propei�y, _
72Z -3�• 0/ zlL • 040 �/ - ��1.0-r�t= LDT/33
(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 fiirther 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.
Prop wrier Name (Pie nt
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF Q
AC )VLEDGED BEF E THIS DAY OF -C , 20_/
B r��jp5�44IS PERSONALLY KNOWN TO ME R WHO HAS
OF NOT
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
SHERRI(FEHLMAN
*4'0F
Commission # GG 187160Expires
March 14 2022
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