HomeMy WebLinkAboutfilled lands affidavit PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
COILIINTY
2300 VIRGINIA AVENUE RECEIVED
FORT PIERCE,FL 34982-5652
(772)462-1553
MAR 3 0 2022
FILLED LAND AFFIDAVIT St.Lucie County
Permitting
1, the undersigned, am the owner of the following described property,
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(Parceild#HL�C-gal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this. Final Development Permit, BP Number QAVc\ ,;®- _ 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.
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Property wner Name.(Please Print)
Proper Owner Sib ture Date
STATE OF FLORIDA,COUNTY OF n+ —
QQAACKNOWLEDGED BEFORE ME THIS_ y ' DAY OF �-e brut-��1 20 ,
BY L Lj n CJdle WHO IIS9 upPERSONALLY KNOWN TO ME( OR WHO HAS
PRODUCED 9—f10L&A—io A°^"' AS IDENTIFICATION.,
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SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
f^j�COMMISSION NUMBER
Notary Public State of Florida
Martha Cabrera
+A My commission GG 244777
OF Expires 08/0112022
SLCPDSD Revised 04/11/201 I