HomeMy WebLinkAboutFilled Land Affidavitr PLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building &c Code Regulations Division
23.00 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(172) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
,31 r �/G5f
(Parcel Id#/Legal description/Address)
I&
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, anti 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.
W. Bryan Adams
Owner Name Please Print)
Property Owner Signature 1LZz- 2 /
Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS Z DAY OF
BY W. Bryan Adams 20�
_WHO IS PERSONALLY KNOWN TO ME (� OR WHO HAS
PRODUCED
AS IDENTIFICATION.
fyU n/Q Hannah Moore*
SIGNATURE OF NOTARY PUBLIC
TYPE OR PRINT NOTARY
017099 COMMISSION NUMBER
(SEAL)
°w* Notary Public State of Flores
Hannah E Moore
SLCPDSD Revised 04/1I/201 I �;' d'°f MY Commission HH 017099
Of R Expires 07/012024