HomeMy WebLinkAboutFILLED LAND AFFIDAVITRECEIVED JUN 12 2017
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
31-1C),;?-604-- -aoo-1/
(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 adverselyaffect the immediate
community.
Property Owner Name (Plyge Print)
11-7
Property owner Signature Date
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME TINS 5 DAY OF�'=
By _WHO IS PERSONALLY KNOWN TO ME
PRODUCED
20 12
✓ OR WHO HAS
AS IDENTIFICATION.
,�/� /��✓c�r� � �(-� /sue-/'L�
SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY
C,& 02 '9561COMMISSION NUMBER
.kPAPAY (9fiAR.HELSETH
* MY COMMISSION / G0 028507
H,, a EXPIRES: September 21,2020
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SLCPDSD Revised 08/24/2010