HomeMy WebLinkAboutFilled Land Affidavit{
PLANNING & DEVELOPMENT SERVICES DEPARTMENT'
• Building &c Code Regulations Division
2300 VIRGINIA AVENUE -
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal description/
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 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 2 2L
Date
STATE OF FLORIDA, COUNTY OF St Lucie
ACKNOWLEDGED BEFORE ME THIS Cl DAY OF �C 20ZZ
BY W. Bryan Adams
_WHO IS PERSONALLY KNOWN TO MEj OR WHO HAS
PRODUCED
� n AS IDENTIFICATION.
I r W UM Hannah Moose
`SIGNATURE OF NOTARY PUBLIC
TYPE OR PRINT NOT
017099 COMMISSION NUMBER
(SEAL
5TED
State of FlOride
oore
SLCPDSD Revised 04/I 1/2011 — HH 017pgg/2024