HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300:VIRGMIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT -.
I, the undersigned, am the owner of the following described property,
(Pareel IM/Legal description/Address) 00 S6 ^ 000
for which I :have applied to St. Lucie ,County for a Final Development Permit. accepting this Final Development Permit; BP' Number In
that As. owner, of the above described property, and in 'accordance I with Section ge
7.04on
A1(D), St . Lucie County Land. Development Code, I shall be responsible for assuring
adequate drainage so that the itrimediate community WILL, NOT, be adversely affected.
I fiirfher 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.
Brian Davidson
Property: caner Name:(Please Print)
5/17/17
Property Owner Signature
Date'
STATE OF FLORIDA, COUNTY OF Brava rd
ACKNOWLEDGED BEFORE ME THIS 17 _DAY OF May
BY ,?0 17
WHO IS PERSONALLY KNOWN TO ME (X ),OR W140 HAS
RODID
AS IDENTIFICATION..
sanr�l-a Leoire
S E'OF NOTARY PUBLIC
TYPE OR PRINT NOTARY
COMMISSION NUMBER '
(SEAL)
SLCPDSD Revised 0411 i/2011 zopAl P%, Notary Public State of Florida
Sandra Leone
y cv a My Commission GG 020251
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