HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
23.00 VIRGINIA AVENUE
FORT PIERCE; FL 34982-5652
(772)462-1553
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FILLED LAND AFFIDAVIT '' titi0ti ti
I, the undersigned, am the owner of the following described property,
(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
acknowledge
that as owner of the above described property, and .in accordance I with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible fbr 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 riot adversely affect the immediate
community.
W. Bryan Adams
ZOwner Name Please Print)
/ 9/2 Z_
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS DAY OF {(Z�Gl� 20 LZ
BY W. Bryan Adams —'
_WHO IS PERSONALLY KNOWN TO MEj OR WHO HAS
PRODUCED
AS IDENTIFICATION.
Hannah Moose
SIGNATURE OF NOTARY PUBLIC
TYPE OR PRINT NOTARY
017099 COMMISSION NUMBER
(SEAL)
ov ° 4P-' .* Notary Public State or Flores
Hannah E Moore
SLCPDSD Revised 04/1 1/2011 �;�d MY com-'... HH 017099
or Expires 07/012024