HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
_ 2300 VIRGINIA AVENUE
FORT -PIERCE, FL 349.82=5652,
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
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(Parcel Id#/Legal description/Adi
o /-/ 4olvE AtiE
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development. Permit, BP Number , 1 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.
51� yz ,4 s � m o �✓
Property Owner NamLlease Print)
aL
Prop er gnature Date
STATE OF FLORIDA, COUNTY OI7V 4)c�1)e.
ACKNOWLEDGED BEFORE 1v1ETHIS DAY OF 60ne 20
BY E 1,�Q� J \n—\ QNrN WHO 1S PERSONALLY KNOWN TO ME C) OR WHO HAS
OF NOTARY PUBLIC
`0 SSION NUMBER
SLCPDSD Revised 04/1 I2011
TYPE OR PRINT NOTARY
?o�'a ••.,���o BARBRA A. GOODMAN
* * MY COMMISSION �HEMPII
N, EXPIRES: March 12, 2018
9"fow Bonded Thru Budget Notary Servlcm
IDENTIFICATION.