HomeMy WebLinkAboutFilled Land Affidavit9
'COUNTY-
-K L O .R�
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, Fl, 34982-5652
(772)462-1553
FILLED LA1NDS AFFIDAVIT
1, the undersigned, am the owner of the following described 'property,
56-50/- 602-2- 90®^ I
(Parcel Id#/Legal description/Address)
for which 1 have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number _
that as owner of the above described property, and in accordance I with Section
acknowledue
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community AIL 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.
Property Owner Name (Please Print)
l� i a zt t Property Owner Signature
Date
STATE OF FLORIDA. COUNTY OFM . ty& -
ACKN WLHUGED BEFORE' ME THIS `�� 1
-- DAY OFW �i"�' 20 I
BY j. w l l' lo-Kj
_,_WHO IS PERSONALLY KNOWN TO ME OR W140 HAS
YRODUC ii) .
qv��
�J-7 (AS IDENTIFICATION.
ATLII : QP NQ7 A'h t 1 U✓
[[�� rYPF. )R 11 r NQl'ARY
2zVf6—__—COMMISSION NUMBER
REi
State of F(&06L)
atoson EE 224190
/2016
SLCPDSD Revised 08/24/2010