HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
F Building & Code Regulations Division
• ni 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the followingidescribed property,
—60 9—boo -_j
(Parcel Id#/Legal description/Address)
Lv 3
ai-g Z-LI
( &Ii'o Z
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.
�6 as, �•
Property Amer Name (Pleas Prim
STATE OF
COUNTY OF c7��
407 .2 $ 7
D� e
ACKNOWLEDGED BEFORE ME THIS alBt�' DAY OF 20 1,
BY v �()M I pQ`�CGCSC7 t� WHO IS PERSO ALLY I.NOWN TO ME (J OR WHO HAS
V
PRODUCED VL- enj Z/S /ZO%S AS IDENTIFICATION.
4 1 0tOTARY PUBLIC
OMMISSION NUMBER
SLCPDSD Revised 04/11/2011
. M&M ly�3� -t . to
\VPE OR PRINT NOTARY
4 mmipe A Reid
NOTARY PUBLIC
STATE OF FLORIDA
. Ca reW 00016036
Ejires 7/27/202 tj