HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34§82-5652
(772) 462-1553
FILLED LANDS AFFIDAVIT
I, the undersi ned, am the owner of the foll wing described property,/JJV 06• Dd/d • 660 ;S
(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 dr •nage off my property which will not adversely affect the immediate
community.
Property O rerreelse Print)
l�c► 7
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF v l - I C. e-
ACKNOWLEDGED BEFORE ME THIS / ! DAY OF , 201
BY W lI Il a AQ 1/4-44 d,ke WHO IS PERSONALLY OWN TO ME_ ZR WI40 HAS
AS IDENTIFICATION.
ARY PUBLIC TYPE OR PRINT NOTARY
(�\ COMMISSION NUMBER aID-j"1a
�ebecc GO ss�� # (SEAL)
�• ��-; Comminary 9.20� Y Banded �N
SLCPDSD Revised 08/24/2010