HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
23.00 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
�?6 9� We-ki-s-(bA b115�
(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.
W. Bryan Adams
Owner Name Please Print)
Property Owner Signature IZ 2!
Date 15 "
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS 15 DAY OF_ " 1p�/
BY W.Bryan Adams , zoo_,
_WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED
��y ,� AS IDENTIFICATION.
L I r O UAJ Hannah Moore
(isrb�GNATURE OF NOTARY PUBLIC
TYPE OR PRINT NOT
017099 COMMISSION NUMBER
(SEAL
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ooreSLCPDSD Revised 04/11/2011 .. HH 017099
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