HomeMy WebLinkAbout1707-0182 FILLED LAND AFFIDAVIT■ 1'�6� e�r�a
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
4'
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
.'3L4o,-A CODS- Do-7.2 ®o o -5
(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 r'r
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. .
9 q � r-, 01 -)s'—? �J'
Property Owner Name (Please Print)
'1 � ►1 1201 `�
Properly er Signature Date
STATE OF FLORIDA, COUNTY OF &S(1 n1 n
ACKNOWLEDGED BEFORE ME THIS �— DAY OF V `lI , 20 _I
BY jqCII`Jl lMQnd D • Wir i bi2i )r WHO IS PERSONALLY KNOWN TO ME OR WHO HAS
PRODUCED E l o6 d Cal Zir�.V er S G cen'r_ AS IDENTIFICATION.
X&A r� i cal e Dig -a clj
SIGNAIURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
0Q3'9COMMISSION NUMBER
(SEAL)
NICOLE ORTADO
NOTARY PUBLIC
STATE OF FLORIDA
SLCPDSD Revised 08/24/2010 Comm# FF180038
*QVCjS1Expires 12/1/2018