HomeMy WebLinkAboutFilled Land Affidavit4
PLANNING & DEVELOPMENT SERVICES DEPARTMENT'
Building & Code Regulations Division
• 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652 FRECEIVED..
(772) 462-2-1553
FILLED LAND AFFIDAVIT I - I OCT 2 7 2017
Permitting Department
St. Lucie County, FL
I, the undersigned, am the owner of the following described property,
10± �` XV " Mc4n V -A CU' mod-- B � K `-A 11 1AUS—
(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.
Property Own4 Name (Please Print)
Property Owner gnature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF _� 20 t ,
BY WHO IS PERSONALLY KNOWN TO ME &hOR WHO HAS,
PRODUCED AS IDENTIFICATION.
%35&z,_COMMISSION
NUMBER
SLCPDSD Revised 04/11/2011
TYPE
HEATHER HARDEN
ggmmi8&14n #(0%X0312
a 14tornmissian Expires
28, 2020